Mechanical Ocular Trauma in Children
Ocular trauma is the major cause of unilateral blindness in children [1, 2]. Seven to thirteen percent of the patients who suffer from ocular trauma have a significant lower vision and blindness [3, 4]. Thirty-five percent of approximately 2.5 million ocu
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Mechanical Ocular Trauma in Children Gokhan Gurelik and Sabahattin Sul
6.1
Introduction
Ocular trauma is the major cause of unilateral blindness in children [1, 2]. Seven to thirteen percent of the patients who suffer from ocular trauma have a significant lower vision and blindness [3, 4]. Thirty-five percent of approximately 2.5 million ocular injuries were encountered in children younger than 17 years old [4]. In Nepal, incidence of ocular trauma (cases that did not require hospitalization were included) was estimated as 300 per 100,000 per year [5]. The incidence of hospitalization due to ocular trauma varies from 8.85 to 22.5 per 100,000 per year [6, 7]. Pediatric ocular trauma does not receive accurate attention even if it is the most common cause of acquired blindness (Fig. 6.1). Approaching and the management of pediatric cases resemble to those in adult cases; nevertheless, pediatric ocular trauma has unique features different from adult ocular trauma. Documenting a reliable history and mechanism of trauma and performing ocular examination are difficult in an injured child. Furthermore, ocular trauma usually affects an immature visual system that is
G. Gurelik, MD (*) Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey e-mail: [email protected] S. Sul, MD Department of Ophthalmology, School of Medicine, S Kocman University, Mugla, Turkey
expected to develop up to 9 years old; in other words, amblyopia becomes a major concern following the initial treatment of trauma [8, 9]. Therefore, approaching to ocular trauma in children is different from the adults in some ways and requires special attention. In this chapter, we described the epidemiological and clinical characteristics, hot topics in the current understanding, current consensuses, controversial areas, and treatment of mechanical ocular trauma in children.
6.2
Epidemiological and Clinical Characteristics of Mechanical Ocular Trauma in Children
Ocular trauma may affect children at any age but peak incidence is about 5–9 years [10]. Boys are affected about two or four times more than girls [11, 12]. Ocular trauma generally occurs at home [10, 11, 13]. In our study representing 182 pediatric open globe injuries in Turkish population, 45.1 % of injuries occur at home [12]. Particularly, infants and younger children are at great risk at home without adult supervision. Furthermore, immature motor-mental skills, carelessness, and uncontrolled emotions increase the rate of home injuries in younger children [6]. The incidence rate of outdoor places such as streets and roads and school tends to increase in older children [13].
© Springer Science+Business Media Singapore 2017 H. Yan (ed.), Mechanical Ocular Trauma, DOI 10.1007/978-981-10-2150-3_6
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(all kinds of explosive agents)-related ocular injuries were creating a burst incidence during especially at short-term festival-like holidays in Turkish children. Nowadays, this kind of injuries occurs very rare after rigid prohibition of explosi
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