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Journal Article

Citation

Richards MD, Barnes K, Yardley AE, Hanman K, Lam GC, Mackey DA. BMJ Open Ophthalmol. 2019; 4(1): e000215.

Affiliation

Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia.

Copyright

(Copyright © 2019, BMJ Publishing Group)

DOI

10.1136/bmjophth-2018-000215

PMID

31179388

PMCID

PMC6528766

Abstract

OBJECTIVE: This study aims to evaluate the presenting characteristics, management, outcomes and complications for paediatric traumatic hyphaema in Western Australia.

METHODS AND ANALYSIS: A retrospective review of medical records was conducted for consecutive patients ≤16 years of age admitted for traumatic hyphaema to Princess Margaret Hospital for Children (Perth, Australia) between January 2002 and December 2013 (n=82). From this sample, a cohort whose injury occurred ≥5 years prior attended a prospective ocular examination (n=16). Hospital records were reviewed for patient demographics, injury details, management, visual outcomes and complications. The prospective cohort underwent examination for visual and structural outcomes.

RESULTS: Most injuries (72%) resulted from projectile objects. Angle recession was present in 53% and was associated with projectiles (p=0.002). Most eyes (81%) achieved a final visual acuity of 0.3 logarithm of the minimum angle of resolution (logMAR) (20/40) or better. Age ≤5 years and posterior segment injury were significant predictors of final visual acuity poorer than 0.3 logMAR. At ≥5 years post-trauma, injured eyes had greater intraocular pressure (IOP) (p=0.024) and anterior chamber depth (ACD) (p=0.022) compared with sound eyes. IOP asymmetry was associated with angle recession (p=0.008) and ACD asymmetry (p=0.012).

CONCLUSION: Poorer visual outcomes are associated with younger age at injury and posterior segment injury. Angle recession and ACD asymmetry are associated with IOP asymmetry 5-12 years after injury.


Language: en

Keywords

anterior chamber; child health (paediatrics); trauma

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