Open globe injuries in children.

BACKGROUND: Eye injuries are the leading cause of monocular blindness in children. 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 classified and the severity of injury was categorized in four grades.

RESULTS: Our series included 5 eyes (13%) with a rupture, 30 (79%) with a penetrating and 3 (8%) with a perforating injury. Follow-up varied from 3 days to 7 years (mean 15.5 months). The macula was attached at the last follow-up in all eyes. The final visual acuity ranged between 1.0 and light projection. In 47% of cases (18 eyes), the visual acuity was > or =0.5; 74% (28 eyes) achieved at least 0. 1. Eighteen of 38 eyes (47%) had severe injury with posterior segment involvement. Visual acuity of at least 0.5 was achieved in 44% (8/18) of these. Eyes with grade 2-4 injury treated with early vitrectomy had a final visual acuity of > or =0.5 in 58% of cases (7/13). Twenty-one (55%) of 38 children were < or =8 years of age and eight of them (38%) had a final visual acuity of > or =0.5.

CONCLUSION: Salvage of the eye with an attached macula was possible in all eyes. Even in severely injured eyes good visual acuity can be established in about 50% of cases.