PURPOSE:
To study Visual outcome and Prognostic factors of open globe injury in Paediatric age group (<=18 yrs)

Lavanya Rao

METHOD:
Retrospective observational study of 82 cases was done from January 2000 to April 2010. Eyes were categorized as per ocular trauma classification. Final Visual Acuity (VA) was assessed at 6 months and categorized as per WHO classification of visual impairment. Factors at presentation, complications and additional procedures done were evaluated for prognostic value. 72 eyes whose VA could be assessed at 6 months follow up were included for statistical analysis (Univariate Analysis).

RESULTS:
63 cases (76.8%) were males. Average age of presentation was 10 yrs. Of the 65 eyes whose initial VA could be assessed, 8(12.3%) had >=20/40, 38(58.5%) had Hand Movement (HM) or less.
Of 72 eyes whose VA could be assessed at 6 months, 36(50%) had >=20/40, and 19(26.4%) had HM or less.
1 case underwent evisceration (Ocular survival 98.78%).
Univariate analysis showed that Grade IV/V injury, length of wound, zone of Injury, Hyphema, presence of Retinal Detachment and Ocular Trauma Score were significant predictors of final visual outcome. Cataract, IOFB, Iris prolapse were not found to be significant predictors.
None of the additional procedures done were found to be significant predictors of the final visual outcome.

CONCLUSION:
Wound length, zone of injury, Hyphema, presence of Retinal Detachment, Ocular Trauma Score and Poor vision at presentation were significant prognostic factors. Poor VA at presentation need not be associated with poor visual outcome.