Research Article
An Important Cause of Blindness in Children:
Open Globe Injuries
Meral Yildiz,
1
Sertaç Argun KJvanç,
1
Berna Akova-Budak,
1
Ahmet Tuncer Ozmen,
1
and SadJk Gorkem Çevik
2
1
Department of Ophthalmology, Uludag University, School of Medicine, 16059 Bursa, Turkey
2
Department of Ophthalmology, S ¸evket Yılmaz Training and Research Hospital, 16310 Bursa, Turkey
Correspondence should be addressed to Sertac ¸ Argun Kıvanc ¸; sakivanc@gmail.com
Received 21 January 2016; Revised 10 April 2016; Accepted 19 April 2016
Academic Editor: Marcel N. Menke
Copyright © 2016 Meral Yildiz et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective. Our aim was to present and evaluate the predictive factors of visual impairment and blindness according to WHO criteria
in pediatric open globe injuries. Methods. Te medical records of 94 patients younger than 18 years who underwent primary repair
surgery were reviewed retrospectively. Te initial and fnal visual acuity, anterior and posterior segment fndings, and zone of
injury were noted. Te patients were classifed as blindness in one eye or visual impairment in one eye. Results. Of 412 patients who
presented with open globe injury, 94 (23%) were under 18 years old. Fify-four (16 females, 38 males) children were included. Te
mean age of the children was 7.1 ± 4.1 years. According to WHO criteria, 19 of 54 patients (35%) had unilateral blindness and 8
had unilateral visual impairment (15%). Tere was no signifcant relationship between fnal visual acuity and gender and injured
eye. In visually impaired and blind patients, presence of preoperative hyphema, retinal detachment, and zone 2 and zone 3 injuries
was signifcantly higher. Conclusion. Presence of hyphema and zone 2 and zone 3 injuries and retinal detachment may end up with
visual impairment and/or blindness in children.
1. Introduction
Globally, an estimated 70 million blind person-years are
caused by childhood blindness. Approximately 500.000
children become blind every year [1]. In least developing
countries congenital and developmental cataract, retinal
pathology, and congenital anomalies are the main causes of
nontraumatic blindness [2]. Ocular trauma is an important
cause of eye morbidity and leading cause of noncongenital
monoocular blindness among children [3–5]. Worldwide,
eighteen million people have uniocular blindness from
traumatic injury and every year a quarter of a million of
children present with serious ocular trauma [6]. Two percent
to 14% of the pediatric ocular trauma patients ended in
visual impairment or blindness [7–9]. In this study, our aim
was to present and evaluate the predictive factors of visual
impairment and blindness according to WHO criteria in
pediatric open globe injuries.
2. Methods
Of 412 patients who underwent primary repair surgery
because of open globe injury at Department of Ophthalmol-
ogy, Uludag University, between January 2010 and December
2014, the medical records of 94 patients who were younger
than 18 years were reviewed retrospectively. Te Uludag
University Hospital administration approved the study. Te
patients younger than 18 years old with at least 6 months of
follow-up were included. Te exclusion criteria were closed
globe injury and major head trauma which might have
injured chiasmal and retrochiasmal optic pathways. Te ini-
tial and fnal examinations of the patients were evaluated. Te
initial visual acuity, fnal visual acuity, anterior and posterior
segment fndings, zone of injury, computed tomography, and
ultrasound fndings were noted.
Zone of injury was classifed according to Ocular Trauma
Classifcation Group: zone 1 as wound involvement limited
Hindawi Publishing Corporation
Journal of Ophthalmology
Volume 2016, Article ID 7173515, 5 pages
http://dx.doi.org/10.1155/2016/7173515