Clinical Profile, Etiology, and Management Outcomes of Pediatric Ocular Trauma in Saudi Arabia.

Objective: To evaluate cases of pediatric ocular trauma at a tertiary eye hospital in central Saudi Arabia and determine the demographics, causes, ocular injuries, and visual status before and after management.

Methods: A retrospective review was performed of health records of children younger than 16 years with ocular trauma managed from January 1998 to December 2019. Data were collected on patient demographics, eye involved, cause of trauma, the presenting and final vision, and the duration of follow-up. Best-corrected visual acuity at the last follow-up was compared between open and closed eye injury groups. The Birmingham Eye Trauma Terminology was used to classify the ocular injuries.

Results: Among 1003 patients, 728 (72.6%) had open globe and 275 (27.4%) had closed globe injuries. The main causes of trauma were unsafe playing-related activities (n = 394; 39.3%), unsafe home environment (n = 158;15.8%) and injury by metallic objects (n = 166; 16.6%). Gunshot-related ocular trauma was noted in 62 (6.2%) children. Presenting vision less than 20/400 was noted in 292 (40.1%) eyes with open globe injuries and 110 (40%) eyes with closed globe injuries (P = 0.4). After a median follow-up of 13.3 months, best-corrected visual acuity was 20/20 to 20/200 in 393 (53%) eyes with open globe injuries and 137 (49.8%) eyes with closed globe injuries (P = 0.03).

Conclusions: Despite proper management, children in this study sustained significant permanent visual loss secondary to ocular trauma. Public health efforts in Saudi Arabia are needed to reduce preventable injury-related childhood blindness.