Open globe injuries in children

Background: Eye injuries are the leading cause of monocular blindness in ch ildren. At present, however, only limited follow-up studies exist. Methods: The files of 38 consecutive patients aged 16 years or younger who had been treated for open globe injuries were examined. The type of injury was clas sified and the severity of injury was categorized in four grades. Results: Our series included 5 eyes (13%) with a rupture, 30 (79%) with a penetratin g and 3 (8%) with a perforating injury. Follow-up varied from 3 days to 7 y ears (mean 15.5 months). The macula was attached at the last follow-up in a ll eyes. The final visual acuity ranged between 1.0 and light projection. I n 47% of cases (18 eyes), the visual acuity was greater than or equal to 0. 5; 74% (28 eyes) achieved at least 0.1. Eighteen of 38 eyes (47%) had sever e injury with posterior segment involvement. Visual acuity of at least 0.5 was achieved in 44% (8/18) of these. Eyes with gl ade 2-4 injury treated wi th early vitrectomy had a final visual acuity of greater than or equal to 0 .5 in 58% of cases (7/13). Twenty-one (55%) of 38 children were 18 years of age and eight of them (38%) had a final visual acuity of greater than or e qual to 0.5. Conclusion: Salvage of the eye with an attached macula was pos sible in all eyes. Even in severely injured eyes good visual acuity can be established in about 50% of cases.