Peer-review started: November 8, 2016
First decision: November 30, 2016
Revised: January 20, 2017
Accepted: February 5, 2017
Article in press: February 7, 2017
Published online: February 12, 2017
To quantify and characterize children and adolescent eye injuries treated in trauma department.
A retrospective analysis was conducted of children and adolescent patients (0-19 years of age) with eye injuries using the British Columbia Trauma Registry (BCTR) data. BCTR data was obtained from January 1, 2000 to December 31, 2008. The BCTR provides the most detailed information on severe injuries throughout the province of BC. There are 12 trauma-receiving facilities in BC from which BCTR collects data.
A total of 162 patients with eye injuries were registered in BCTR during the data collection period. The highest number of injuries occurred in the 15-19 age group, followed by 10-14 and 5-9 age groups. Seventy-one point six percent of all patients were male. The mean age for all patients was 12.9 (SD = 5.8) years. Vehicular crash was by far the most common mechanism of injury among all patients (42.0%) followed by blunt injury (14.2%) and cuts (12.3%). The child and adolescent eye injury data set we used for our study indicated that there were in total, 50 patients that were tested for alcohol and drug use. The majority of them were 15-19 years of age (n = 38). Among the tested eye injury patients in the 15-19 age group, 47% (18/38) tested positive for alcohol. There were approximately 30 cases of physical fighting (assault) and fighting-related injury among adolescents. Some injuries were caused by use of fire arms and knife during the assaults. Out of all patients, 62 (38%) were seen by an Ophthalmologist on admission, whereas 100 (62%) patients were not seen by an eye specialist on admission. The most common injury diagnosis among the patients not consulted by ophthalmologist was conjunctiva injury (53%), whereas almost 9 out of 10 patients with ophthalmological consultation had laceration of cornea injury diagnoses. Using Glasgow Coma Scale (GCS)-based classification of brain injury severity, 3.7% of all patients were classified with severe brain injury (GCS ≤ 8), while more than 64% had diagnosed with a mild brain injury (GCS ≥ 13).
This study suggests that most child and adolescent eye injuries in BC occur at street/highway locations followed by incidents at home. Vehicular crash was by far the most common mechanism of injury among all patients (42%). Sixty-four point two percent of child and adolescent eye injury patients also had mild brain injuries. Further, the child and adolescent eye injury data set we used for our study indicated that there were in total, 50 patients tested for alcohol and drug use. There is an urgent need for a child and adolescent eye injury prevention plan in our province.
Core tip: The epidemiology eye injuries among British Columbian children and adolescents have been elucidated using the Trauma Registry data. The finding that approximately 72% eye injury patients in the 15-19 age groups have consumed alcohol prior to injury is unprecedented, important and need a sensible prevention intervention. Moreover, common causes of eye injury in the 15-19 year age group include vehicular crashes, firearm misuse, and assault. Therefore, preventative programs aimed at older children must target the children directly, providing education about potential causes and ramifications of eye injury.