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ARTICLES
Year : 1971  |  Volume : 19  |  Issue : 2  |  Page : 67-70

Ocular injuries in childhood


Department of Ophthalmology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajsthan, India

Correspondence Address:
R P Sarda
Department of Ophthalmology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajsthan
India
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Source of Support: None, Conflict of Interest: None


PMID: 15744972

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How to cite this article:
Sarda R P, Mehrotra A S, Ratnawat P S, Adnani K. Ocular injuries in childhood. Indian J Ophthalmol 1971;19:67-70

How to cite this URL:
Sarda R P, Mehrotra A S, Ratnawat P S, Adnani K. Ocular injuries in childhood. Indian J Ophthalmol [serial online] 1971 [cited 2020 Apr 8];19:67-70. Available from: http://www.ijo.in/text.asp?1971/19/2/67/34989

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Ocular injuries in childhood is in itself an important subject. There are certain injuries which are seen in adults whereas others are more common in children. Playing some games like "Gilli danda" or on Dewali toying with fire crackers leads to a number of cases of eye injuries. Injury with bow and arrow or with pencil point or with sharp instruments or compasses. all these are seen in children of school going age. These lead from minor in­jury to cataract formation or even endophthalmitis if not taken care of early.

A great number of reports are available on various injuries in adults some including all ages, but for childhood injuries, as a separate entity, scanty literature is available (Cooper[1]).


  Material and Methods Top


The present study is based on our observations made on the Ophthalmic injuries to pati­ents admitted in this hos­pital from July, 1968 to Nov. 1969., selecting only the cases up­to 14 years of age (school going age group). A total of 22 such cases were sorted out from 48 cases of injury at all ages, ad­mitted during this period. All cases of minor eye injuries like small corneal foreign bodies, ab­rasions of lid, conjunctival tear not requiring sutures and likewise are treated in out door only, and are therefore not included here, where as cases having perforating injuries, impacted foreign bodies or big tears where surgiacl inter­vention is required are admitted for observation and treatment.


  Observations Top


Some of the observations made in this series are as tabulated be­low:-


  Discussion Top


Trauma is more likely to affect the male population in the wage earning age group. children show a disproportionately high incide­nce of ocular injuries, and the damage sustained is often of a more serious nature (Sorsby[5]).

Out of a total of 48 cases of major eye injuries seen in the last 1½ years in this hospital, 22 (47%) were children of school go­ing age group. Practically similar percentage (40%) is reported by Malik et al [4] in the age group up to 15 years in their study of pat­tern of ocular injuries of all age groups. Holand [2] in a study of 2,309 eye injuries in a period of 11 years gave this percentage to be 21%, out of all injuries, and Kobar [3] (1965) placed childhood injury to 19% of all ocular in­juries in his study of 1,024 cases upto 15 years of age. It is seen here that Indian data shows practically double percentage as compared to the advanced coun­tries which is possible due to the type of games in children and lack of supervision of parents over children, in medium or low class families, which is responsible for the difference.

In children also, male sex predo­minates (77.3%) as it is recorded in the higher group, possibly be­cause of more out door games played by male children viz. gilli­danda, (an Indian outdoor game) etc. which are not common in fe­male children.

Mode of injury and causative agents are also quite interesting.

There is slight difference, possi­bly, in rural and urban popula­tion. Injury by Gilli danda and bow and arrow are more common in rural population, whereas Dewali cracker-injuries and road side accidents are more common in urban population. Out of 6 cases of injury due to Dewali crakers, 2 lost the eye due to retained F.B., one of which is shown in [Figure - 1]. The other one had a round iron F.B. 1.5 cm. in diameter, splintered from a crac­ker which tore the sclera and ciliary body to enter the eye caus­ing a phthysical eye. Sharp ins­truments like pin, kitchen knife etc. are also important as causa­tive agents of eye injuries.

Parts Affected

Cornea has the highest incide­nce (68.1%) of injury possibly due to the fact that it is the most ex­posed part of eye ball. Then come lens and iris in that se­quence.

Visual Loss

In 50%, cases there was no visual loss. These were the cases where either the lids were affected or there were corneal perforations at periphery, without any damage to lens.

Five eyes were lost due to poste­rior involvement in infection and in the other six, lens was dama­ged in various degrees to impair vision from 6/60 to F. C.

Some Interesting Features

Five eyes were lost out of which two were due to Dewali crackers (X-ray plate of one is shown). One case had blunt iron rod in­jury causing hyphaema and vitre­ous haemorrhage with small con­junctival tear. The blood got ab­sorbed within 2 weeks but the case came about 1 month later with marked rise of tension, pro­bably secondary glaucoma, due to blockage of angle of anterior chamber by blood cells. The lens was transparent and in position.

[Figure - 2] shows two wooden foreign bodies, 6.0 and 6.5 cm. X 1 cm. which entered by piercing the lid at the inner angle into the orbit. The eye ball was saved without any injury to it. The F. B.'s were taken out and lid was sutured.


  Summary and Conclusion Top


Modes of ocular injury in child­hood are reported. This gives an incidence of 45% of eye injuries at all ages. Dewali crackers are more dangerous to the extent that out of 5 eyes lost, three were due to this. Cornea shows highest incidence of involvement because it is the most exposed part of the eye ball. Incidence of childhood injuries in Indian reports are higher than those in advanced countries, due to differences in living habits[6].

 
  References Top

1.
COOPER, S. N.: Editorial on Ocu­lar Injuries. J. All India Ophth. Soc. 16:1, 1968.  Back to cited text no. 1
    
2.
HOLLAND G.: Analysis of 2,309 in­juries of the eye and lids. Klin. Mbl. Augenheilk. 145: 915, (1965). Taken from Ophth. Lit. 19: 416. (1965).  Back to cited text no. 2
    
3.
KOBOR, J.: Eye Injuries in Child­hood Klin Mbl. Augenheilk. 146: 740, (1965). (Taken from Ophth. Lit. 19:1467, (1965).  Back to cited text no. 3
    
4.
MALIK, S. R. K., GUPTA, A. K. AND CHAUHAN, S.: A study on pattern of ocular injuries in Delhi. J. All India Ophth. Soc. 16­178, 1968.  Back to cited text no. 4
    
5.
SORSBY, A.: Modern Ophthalmo­logy Vol. III P. 392 Butterworth, London, 1964.  Back to cited text no. 5
    
6.
SHARDA R. P. SHARMA R. G., RATNAWAT P. S.: Eye, E. N. T. J. 49. 179, (1970).  Back to cited text no. 6
    


    Figures

  [Figure - 1], [Figure - 2]
 
 
    Tables

  [Table - 1], [Table - 2], [Table - 3], [Table - 4]



 

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