Skip to main content
SpringerLink
Log in

A modified pediatric ocular trauma score for predicting visual outcome post open globe injury

  • Trauma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To construct a new pediatric ocular trauma score for predicting visual outcome after open globe injuries (OGI) and to compare it to the ocular trauma score (OTS) and pediatric ocular trauma score (POTS).

Methods

This is a retrospective chart review study. For each case, the following data were collected: demographics, mechanism of the injury, initial ophthalmologic findings, presented and last follow-up visual acuity (VA), ocular treatments, and final ocular findings. We then analyzed the risk factors for the poor visual outcome (VA ≤ 20/200), and a modified pediatric ocular trauma score (MPOTS) was constructed accordingly and compared to the OTS and POTS for predicting poor outcome. Finally, a different cohort of pediatric OGIs was used for score validation.

Results

Forty-five cases were included, significant predicting factors for poor visual outcome were initial VA ≤ 20/200, zone 2–3 locations of injury, presence of retinal detachment, vitreous hemorrhage, hyphema, and iris prolapse at initial presentation. The calculated Spearman correlation coefficients between each system score and poor visual outcome were OTS 0.56, POTS 0.57, and MPOTS 0.64 (P < 0.001 for all). A total of 71 new cases were used as validation cohort, and calculated Spearman correlation coefficients between each system score and poor visual outcome were: OTS 0.50, POTS 0.51, and MPOTS 0.53 (P < 0.001 for all).

Conclusions

We suggest a new scoring system for predicting poor final visual outcomes after OGI’s in children, which is simpler and more clinically suitable for this study population. It was found to be a better predictor of visual outcome in this scenario compared with existing scoring systems.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Négrel AD, Thylefors B (1998) The global impact of eye injuries. Ophthalmic Epidemiol 5:143–169. https://doi.org/10.1076/opep.5.3.143.8364

    Article  PubMed  Google Scholar 

  2. Parver LM (1986) Eye trauma the neglected disorder. Arch Neurol 104:1452–1453

    CAS  Google Scholar 

  3. Matsa E, Shi J, Wheeler KK et al (2018) Trends in us emergency department visits for pediatric acute ocular injury. JAMA Ophthalmol 136:895–903. https://doi.org/10.1001/jamaophthalmol.2018.2062

    Article  PubMed  PubMed Central  Google Scholar 

  4. Sii F, Barry RJ, Abbott J et al (2018) The UK paediatric ocular trauma study 2 (POTS2): demographics and mechanisms of injuries. Clin Ophthalmol 12:105–111. https://doi.org/10.2147/OPTH.S155611

    Article  PubMed  PubMed Central  Google Scholar 

  5. Li X, Zarbin MA, Bhagat N (2015) Pediatric open globe injury: a review of the literature. J Emerg Trauma Shock 8:216–223

    Article  Google Scholar 

  6. Birch EE, Castañeda YS, Cheng-Patel CS et al (2019) Self-perception of school-aged children with amblyopia and its association with reading speed and motor skills. JAMA Ophthalmol 137:167–173. https://doi.org/10.1001/jamaophthalmol.2018.5527

    Article  PubMed  Google Scholar 

  7. Kuhn F, Maisiak R, Mann LR et al (2002) The ocular trauma score (OTS). Ophthalmol Clin North Am 15:163–165. https://doi.org/10.1016/S0896-1549(02)00007-X

    Article  PubMed  Google Scholar 

  8. Acar U, Tok OY, Acar DE et al (2011) A new ocular trauma score in pediatric penetrating eye injuries. Eye 25:370–374. https://doi.org/10.1038/eye.2010.211

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Awidi A, Kraus CL (2019) A comparison of ocular trauma scores in a pediatric population. BMC Res Notes 12:10–13. https://doi.org/10.1186/s13104-019-4602-8

    Article  Google Scholar 

  10. Schörkhuber MM, Wackernagel W, Riedl R et al (2014) Ocular trauma scores in paediatric open globe injuries. Br J Ophthalmol 98:664–668. https://doi.org/10.1136/bjophthalmol-2013-304469

    Article  PubMed  Google Scholar 

  11. Vashist P, Senjam SS, Gupta V, et al (2017) Definition of blindness under National programme for control of blindness : do we need to revise it ? Evolution of the World Health Organization Definition of Blindness. Indian J Ophthalomol 65:92–96. https://doi.org/10.4103/ijo.IJO

  12. Pieramici DJ, Sternberg PJ, Aaberg S et al (1997) A system for classifying mechanical injuries of the eye (globe). Am J Ophthalmol 123:820–831. https://doi.org/10.1016/S0002-9394(14)71132-8

    Article  CAS  PubMed  Google Scholar 

  13. Salvin JH (2007) Systematic approach to pediatric ocular trauma. Curr Opin Ophthalmol 18:366–372. https://doi.org/10.1097/ICU.0b013e3282ba54ac

    Article  PubMed  Google Scholar 

  14. Boret C, Brehin C, Cortey C et al (2020) Pediatric ocular trauma: characteristics and outcomes among a French cohort (2007–2016). Arch Pediatr 27:128–134. https://doi.org/10.1016/j.arcped.2020.01.002

    Article  CAS  PubMed  Google Scholar 

  15. Bunting H, Stephens D, Mireskandari K (2013) Prediction of visual outcomes after open globe injury in children: a 17-year Canadian experience. J AAPOS 17:43–48. https://doi.org/10.1016/j.jaapos.2012.10.012

    Article  PubMed  Google Scholar 

  16. Farr AK, Hairston RJ, Humayun MU, et al (2001) Open globe injuries in children: a retrospective analysis. J Pediatr Ophthalmol Strabismus 38. https://doi.org/10.3928/0191-3913-20010301-07

  17. Lee CH, Lee L, Kao LY et al (2009) Prognostic indicators of open globe injuries in children. Am J Emerg Med 27:530–535. https://doi.org/10.1016/j.ajem.2008.04.004

    Article  PubMed  Google Scholar 

  18. Hill JR, Crawford BD, Lee H, Tawansy KA (2006) Evaluation of open globe injuries of children in the last 12 years. Retina 26:65–68. https://doi.org/10.1097/01.iae.0000224668.21622.81

    Article  Google Scholar 

  19. Cohen N, Cohen E, Anafy A et al (2021) Predictors of traumatic eye injuries at high-risk for ophthalmic complications in children. Eur J Pediatr 180:177–185. https://doi.org/10.1007/s00431-020-03734-0

    Article  PubMed  Google Scholar 

  20. Liu X, Liu Z, Liu Y et al (2014) Determination of visual prognosis in children with open globe injuries. Eye (Basingstoke) 28:852–856. https://doi.org/10.1038/eye.2014.108

    Article  CAS  Google Scholar 

  21. Grieshaber MC, Stegmann R (2006) Penetrating eye injuries in South African children: aetiology and visual outcome. Eye 20:789–795. https://doi.org/10.1038/sj.eye.6702003

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, 64239, Israel

    Eyal Cohen, Etti Katzburg & David Varssano

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Eyal Cohen, Gal Antman, Etti Katzburg, Neta Cohen, David Varssano & Gad Dotan

  3. Ophthalmology Unit, Schneider Children’s Medical Center, Petah Tikva, Israel

    Gal Antman & Gad Dotan

  4. Pediatric Emergency Medicine, Dana-Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

    Neta Cohen

  5. Department of Ophthalmology, Medical University of Graz, Graz, Austria

    Marlene M. Glatz

Authors
  1. Eyal Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gal Antman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Etti Katzburg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Neta Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David Varssano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marlene M. Glatz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gad Dotan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by Gal Antman, Etti Katzburg, Neta Cohen, and Marlene Glatz. The first draft of the manuscript was written by Eyal Cohen, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Eyal Cohen.

Ethics declarations

Ethics approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 13 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cohen, E., Antman, G., Katzburg, E. et al. A modified pediatric ocular trauma score for predicting visual outcome post open globe injury. Graefes Arch Clin Exp Ophthalmol 260, 3711–3718 (2022). https://doi.org/10.1007/s00417-022-05723-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-022-05723-5

Keywords

Search

Navigation