Epidemiology, aetiology and outcome of paediatric ocular trauma in Sydney

Aim: Report epidemiology, aetiology and outcomes of eye injuries in children 0–16 years treated at quaternary referral and paediatric hospitals in Sydney, Australia. Methods: A retrospective review of cases January 2009 to December 2015 using hospital diagnostic and International Classification of Diseases, 10th Revision codes. Medical records confirmed open globe injury (OGI) or closed globe injury (CGI) diagnosis and demographic, injury mechanism, ocular and best-corrected visual acuities (BCVA) before and after treatment. Results: A total of 295 patients, 298 eyes were included (96 OGIs, 202 CGIs.) Injuries were commonest in males (72%) with OGI peaks in 3–5-, and CGI, 12–14-year-old males. A projectile was the commonest mechanism (106, 36%) then being struck (101, 34%). Commonest agents were sporting equipment (13%), toys (10%) and sticks (10%). Another child was involved in 32.9% OGI and 27.6% CGI. Initial BCVA was a good predictor of final BCVA. Poor prognostic factors included lens injury, vitreous haemorrhage and relative afferent pupillary defect. Final BCVA 6/12 or better was achieved in 69% cases, including 40% of OGIs and 85% of CGIs. Enucleation and evisceration rates were both 1% (n = 3). Conclusion: Paediatric ocular trauma most commonly occurred in males from projectiles or being struck, with injuries commonly occurring from sporting equipment, toys and sticks. Vision was poorer with open than closed globe injuries.