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Clinical science
Intraocular foreign body injury in children: clinical characteristics and factors associated with endophthalmitis
  1. Yao Yang1,
  2. Chengcheng Yang2,
  3. Ruijuan Zhao1,
  4. Lixia Lin1,
  5. Fang Duan1,
  6. Bingsheng Lou1,
  7. Zhaohui Yuan1,
  8. Xiaofeng Lin1
  1. 1 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
  2. 2 Ophthalmology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
  1. Correspondence to Professor Xiaofeng Lin, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China; linxiaof{at}mail.sysu.edu.cn; Dr Zhaohui Yuan; yuanzhh{at}mail.sysu.edu.cn

Abstract

Background/Aims To analyse the clinical characteristics of intraocular foreign body (IOFB) injury in children and evaluate factors associated with endophthalmitis development.

Methods Patients aged <18 years with IOFB attending Zhongshan Ophthalmic Center between January 2003 and July 2016 were included retrospectively. Demographic features, clinical characteristics and factors associated with endophthalmitis development were analysed.

Results Consecutive subjects (n=484, 484 eyes) were included: mean age 10.12±4.54 years, 86.4% male. Fireworks (28.5%) were the most common cause of injury. Injury of uncertain cause (17.5%), fireworks (36.7%) and metal splatter (31.7%) accounted for most injuries in the 0–3, 4–12 and 13–17 years age groups, respectively. Plant branches (16.7%) and fireworks (31.1%) were the most common causes of injuries in females and males, respectively. Endophthalmitis occurred in 116 patients (24.0%), with metallic IOFB (OR=0.338, p=0.001), intraocular haemorrhage (OR=0.100, p<0.001) and uveal tissue prolapse (OR=0.206, p<0.001) conferring lower risk, while zone II wound (OR=4.336, p<0.001) and traumatic lens rupture (OR=2.567, p=0.028) were associated with higher risk.

Conclusion Clinical characteristics of children with IOFB injury differ from those of adults. Fireworks are the most common cause of injury, indicating a ban on children igniting fireworks should be advocated. Safety education and protective measures should vary by age and sex. Endophthalmitis is associated with zone II wound, traumatic lens rupture, IOFB material, intraocular haemorrhage and uveal tissue prolapse, which has clinical relevance.

  • trauma
  • child health (paediatrics)
  • epidemiology
  • infection
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bjophthalmol-2019-314913

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    Footnotes

    • YY and CY contributed equally.

    • Contributors YY, ZHY and XFL conceived and designed the study. CCY, RJZ and LXL acquired the data. YY, CCY, FD and BSL analysed and interpreted the data. YY and CCY drafted the final manuscript.

    • Funding This work was supported in part by funds from the Natural Science Foundation of Guangdong Province, China (grant number 2018A030313585 and 2018A0303130209), and Fundamental Research Funds of the State Key Laboratory of Ophthalmology (grant numbers 30306020240020130 and 3030902113030).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was conducted in compliance with the principles of the Declaration of Helsinki, and approved by the Institutional Ethics Committee of Zhongshan Ophthalmic Center (Guangzhou, China).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on request.

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