Characteristics of paediatric patients hospitalised for eye trauma in 2007-2015 and factors related to their visual outcomes

Objective To analyse the epidemiological characteristics and clinical features of children under the age of 16 years with ocular trauma at the Eye and Ear, Nose and Throat Hospital of Fudan University (Shanghai, China) and to investigate the preventive measurements taken to avoid vision-threatening eye trauma. Methods The inpatient medical records of children <16 years old treated for ocular trauma between January 2007 and December 2015 were collected. The age, sex, type of trauma, cause of injury, complications and visual acuity on admission and discharge were analysed statistically. Results A total of 2211 patients (2231 eyes) were enroled. Of these, 73.7% were male, and 61.2% were children aged 0-6 years. Mechanical ocular trauma was present in 75.3% of eyes, and penetrating injuries in 59.8%. The top three offending objects were scissors (16.3%), firecrackers (8%) and pencils (4.9%). Iris prolapse (odds ratio [OR] = 2.27), retinal detachment (OR = 2.91), endophthalmitis (OR = 2.25) or an intraocular foreign body (OR = 2.80) was associated with the same or worse visual prognosis among all the subjects. Traumatic cataract (OR = 0.37) was associated with final visual improvement. Conclusions An efficient strategy for preventing eye injury should focus on male children during preschool years. Our root cause analysis showed specific environmental patterns of vision-devastating objects. Specific preventive measures are proposed to reduce the incidence of paediatric eye injuries.