|Year : 1982 | Volume
| Issue : 6 | Page : 561-563
Incidence of trauma in juvenile retinal detachment
Nehru Institute of Ophthalmology and Research, Eye Hospital, Sitapur, India
A K Paul
Eye Hospital Sita Pur 261001
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Paul A K. Incidence of trauma in juvenile retinal detachment. Indian J Ophthalmol 1982;30:561-3
Retinal detachment in children is relatively uncommon and though the juvenile retinal detachment form a small part of the work of retinal detachment Unit, the incidence of trauma as an etiological factor is high, a majority are due to contusion injury followed by smaller group due to indirect trauma or perforating injury.
The purpose of this paper is to report our experience over the past 6 years about the role of trauma in the etiology of retinal detachment in juveniles.
In a period of just over 6 years, 76 cases of retinal detachment have been dealth with in the age group of I -- 20 years, [Table - 1]. The cases were divided into two groups. In the first group i.e. in the age group 1 -10 years, there were 9 cases and in the second group i.e. in the age group of 11-20 years, there were 67 cases. Both eyes were affected in 7 cases, making a total of 83 eyes.
The table shows maximum number of cases in the second decade of life and preponderance of boys were more in the present series of cases.
Although the traumatic detachments are grouped together, the majority are due to contusion injuries [Table - 2]. Indirect trauma or penetrating injury consist of very small number of cases. In the traumatic group,
t h ere is a marked predominance of boys over firls, with 35 boys and 6 grils being involved. The small number of the cases with penetrating injuries related to the greater damage which occurs in this type of injury and the eye is lost altogether and no surgical procedure could be possible in these cases.
Contusion injuries accounts for 29 of the total and nature of injuries including tennis balls, shuttle cock, football, circket b Al.. first and some toys; of 8 cases of indirect traumaaccident, falling off stair case and some toys, involving striking the head are among the injuries reported. 4 cases of penetrating injury include few cracker explosion, sharp toys and one case hit by pencil.
The distribution of the the types of tear in relation to the aetiology emphasizes the predominance of traumatic detachment in this age group and the frequency with which a dialysis is the retinal disturbance giving rise to a detachment. A careful examination by indirect ophthalmoscopy and also examination with the Goldman 3-Mirror contact lens is important. The incidence of dialysis is significant lens in traumatic group of detachment. A total of 26 dialysis, of which 21 were definitey following trauma. Only 4 dialysis were found in spontaneous group and I in uncertain origin [Table - 3]
As regard refractive error of the cases a fairly high proportion of the total series of cases were either emmetropic or hypermetropic. 32 were myopics [Table - 4]
The time interval in our series between the injury and development of detachment has been found to vary from 2 months to 2z years. Hudson series shows to vary from I months to 3 years but Schepens reported much longer time between injury the onset of symptoms anything upto 40 years.
The surgical treatment of retinal detachment in children follows the same principles of technique used in adults. It should be simple which can create a permanent chorioretinal adhesive around the retinal break.
In our series 73 eyes were subjected to surgery. Plombs, segmental scleral indentation, encircling silicon strip or rod were different procedures adopted single or in combination-each is used with cryo therapy or photocoagulation. Surface diathermy was also used in some of the cases. Subretinal fluid was drained in most of the cases. Dialysis with detachment case were treated by segmental indentation with plomb or scleral infolding and some case were also combined with encircling procedure. The result of treatment are shown in [Table - 5]. A successful result was recorded if the retina was flat with good visual acuity during the whole follow up period, which varied from 3 months to 3 years.
The functional success of operative cases are more important than the anatomical replacement of retina. The pre and post operative visual acuity of the 73 operated cases are given in [Table - 6].
| Summary|| |
Though the juvenile retinal detachment form a small part of work of a retinal unit, the incidence of trauma as an etiological factors is high. A study is made of 83 eyes in 76 children in a period of little over 6 years. The causative factor are reviewed. 41 eyes were affected by trauma. The method of treatment and the result of the operated cases are discussed.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5], [Table - 6]