Evaluation and classification of pediatric ocular trauma

Purpose: To offer to the pediatric emergency physician consistent and unamb iguous terms for the description of pediatric ocular trauma, based upon an adapted version of a standardized classification system. To show the potent ial effect of this reclassification system in a tertiary care emergency dep artment, Methods: The authors reviewed a new classification system of ocular trauma and adapted it for use by pediatric emergency physicians. In addition, a re trospective analysis of the records of pediatric patients presenting over a 2-year period to a tertiary emergency department with ocular complaints wa s performed, The diagnoses related to ocular trauma were reclassified accor ding to the new classification system. Results: Over a 2-year period, 117 pediatric patients were evaluated for op hthalmic complaints. Sixty-seven (57%) of these cases involved an ocular co ntusion or ruptured globe; however, six disparate diagnoses were given. The cases were reclassified into an adapted, unambiguous, classification syste m. In some cases, the reclassification altered the indication for immediate ophthalmologic referral. Conclusion: There is currently no standardized system of terminology to des cribe pediatric ocular trauma. This may lead to confusion in communication among the pediatric emergency physician, the pediatrician, and the ophthalm ologist. Consistent, unambiguous, terminology will assist in this communica tion, facilitate the writing of peer-reviewed articles and case reports, an d increase the level of accurate documentation in the medical record.