Pediatric Open Globe Injuries Occurring at Home: A 12-Year Case Series

Objectives: In children, ocular trauma occurs disproportionately in the home. The purpose of this study is to evaluate the epidemiology, characteristics, and outcomes of pediatric traumatic Open Globe Injuries (OGI) occurring at home, and to compare the observed final Visual Acuity (VA) to the Ocular Trauma Score (OTS) expected VA. Methods: Retrospective chart review of pediatric (ages 0-19) patients with traumatic OGI that presented to University Hospital, Newark and Rutgers New Jersey Medical School between 19972008. Results: Eighty-nine pediatric OGI were identified of which 42 (47%) occurred at home (mean age 5.8 years [range 1-19], 64% male). Penetrating injuries represented 79% of cases, while ruptures comprised the remaining 21%. The most common cause of injury was poking with a sharp object (38%). The most common objects involved in these injuries included broken glass, pens, furniture, knives, screwdrivers, wooden sticks, and toys. Self-injury occurred in 57% cases; siblings were involved in 19% of cases. Retinal detachment occurred in 9 (21%) cases. A comparison with 47 pediatric OGIs that occurred outside of home revealed that injuries at home are more likely to occur in younger children, have better initial and final VA, and are more likely to be penetrating injuries. Conclusions: Nearly half of the pediatric OGI in this study occurred at home. Self-injury was the most common cause (57% cases), which emphasizes the need for close supervision of young children. Visual prognosis for pediatric OGI remains poor. The final VA predicted by OTS correlated with the observed final VA.