Document Detail

Outcome and prognosis of pediatric patients with delayed diagnosis of open-globe injuries.
MedLine Citation:
PMID:  19645396     Owner:  NLM     Status:  MEDLINE    
PURPOSE:Open-globe injuries in children can present in a delayed fashion, potentially increasing the risk of endophthalmitis and delaying surgical intervention. This article presents the outcome of pediatric patients with delayed diagnosis of open-globe injuries for 24 hours or more. METHODS:The study was a retrospective observational case series of patients who presented with open-globe injuries diagnosed 24 hours or more after the injury between July 2002 and March 2007. RESULTS:Thirteen patients were included in the study. The average age at presentation was 5.8 +/- 2.8 years; average follow-up was 11.5 +/- 14.5 months. Mean time of presentation after injury was 9.2 +/- 16.0 days. The most common chief complaints were chronic red eye (7 of 13 patients), eye pain (5 of 13 patients), and decreased vision (4 of 13 patients). All patients had self-sealing corneal wounds; 8 of 13 patients had a visually significant traumatic cataract. One patient had sympathetic ophthalmia. Initial visual acuity was 20/200 or worse in 10 patients, and final visual acuity was 20/40 or better in 6 patients. No patient had endophthalmitis. CONCLUSION:Open-globe injuries, especially self-sealing corneal wounds, can present in a delayed fashion in children or may be missed if obvious findings, such as subconjunctival hemorrhage or prolapsed iris tissue, are not present. Pediatricians should be educated that they should maintain a high level of suspicion in the setting of chronic unilateral red eye, decreased visual acuity, or abnormal red reflex.
Olga M Acuna; Kimberly G Yen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-20
Journal Detail:
Title:  Journal of pediatric ophthalmology and strabismus     Volume:  46     ISSN:  0191-3913     ISO Abbreviation:  J Pediatr Ophthalmol Strabismus     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-08-03     Completed Date:  2009-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7901143     Medline TA:  J Pediatr Ophthalmol Strabismus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  202-7; quiz 208-9     Citation Subset:  IM    
Copyright Information:
Copyright 2009, SLACK Incorporated.
Cullen Eye Institute, Baylor College of Medicine, Texas Children Hospital, Houston, Texas, USA.
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MeSH Terms
Child, Preschool
Diagnosis, Differential
Diagnostic Errors
Diagnostic Techniques, Ophthalmological*
Eye Injuries, Penetrating / diagnosis*,  surgery
Ophthalmologic Surgical Procedures / methods*
Retrospective Studies
Time Factors
Trauma Severity Indices

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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