Reid A Ferguson1, Justin Sung2, James McKelvie1,2. 1. Department of Ophthalmology, Auckland Hospital, Auckland, New Zealand. 2. Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
Abstract
IMPORTANCE: Childhood ocular injury is a common, preventable cause of potentially severe permanent disability. BACKGROUND: This study evaluates the nationwide incidence, demographics and visual outcomes of children with ocular injury in New Zealand. DESIGN: Nationwide retrospective review. PARTICIPANTS: All children in New Zealand aged 0 to 17 years from 2007 to 2016 with ocular injury requiring assessment by a medical practitioner. METHODS: New Zealand national and regional datasets were used to evaluate population-level statistics for ocular injury over a 10-year period. Visual and clinical outcome data were assessed using a randomized sample of 150 patients. MAIN OUTCOME MEASURES: Annual incidence, aetiology, demographics, injury location, visual outcomes, protective eyewear use, surgical intervention and follow-up. RESULTS: A national total of 75 601 cases were included with a mean incidence of 719/100 000 children/year. Cases were predominantly male (63.2%) and of New Zealand-European ethnicity (60.8%), aged 0 to 4 years (30.66%). Injury cause was most commonly "struck by object" (53.7%) and occurred in the home (50.9%). Tertiary hospital assessment and treatment was required in 17.7% where final visual acuity of 6/12 or worse was noted in 19.7% and protective eyewear use was reported in 2.7%. Maori and Pacific ethnicities were associated with higher rates of permanent visual impairment. CONCLUSIONS AND RELEVANCE: Children with the highest risk of ocular injury are males aged 0 to 4 years. Children of Maori or Pacific Island ethnicity and aged 15 to 17 years have the highest risk of ocular injury resulting in permanent visual impairment. Protective eyewear use is uncommon in children presenting with ocular injury. Promotion of appropriate injury prevention strategies is an important public health message.
IMPORTANCE: Childhood ocular injury is a common, preventable cause of potentially severe permanent disability. BACKGROUND: This study evaluates the nationwide incidence, demographics and visual outcomes of children with ocular injury in New Zealand. DESIGN: Nationwide retrospective review. PARTICIPANTS: All children in New Zealand aged 0 to 17 years from 2007 to 2016 with ocular injury requiring assessment by a medical practitioner. METHODS: New Zealand national and regional datasets were used to evaluate population-level statistics for ocular injury over a 10-year period. Visual and clinical outcome data were assessed using a randomized sample of 150 patients. MAIN OUTCOME MEASURES: Annual incidence, aetiology, demographics, injury location, visual outcomes, protective eyewear use, surgical intervention and follow-up. RESULTS: A national total of 75 601 cases were included with a mean incidence of 719/100 000 children/year. Cases were predominantly male (63.2%) and of New Zealand-European ethnicity (60.8%), aged 0 to 4 years (30.66%). Injury cause was most commonly "struck by object" (53.7%) and occurred in the home (50.9%). Tertiary hospital assessment and treatment was required in 17.7% where final visual acuity of 6/12 or worse was noted in 19.7% and protective eyewear use was reported in 2.7%. Maori and Pacific ethnicities were associated with higher rates of permanent visual impairment. CONCLUSIONS AND RELEVANCE: Children with the highest risk of ocular injury are males aged 0 to 4 years. Children of Maori or Pacific Island ethnicity and aged 15 to 17 years have the highest risk of ocular injury resulting in permanent visual impairment. Protective eyewear use is uncommon in children presenting with ocular injury. Promotion of appropriate injury prevention strategies is an important public health message.