Our study was started with the aim of increasing awareness and lack of current data on pediatric ophthalmologic trauma in Turkey. This is the first study evaluating ocular trauma in the pediatric age group in our region.
Many epidemiological studies have reported that ocular trauma is more common in men than women [10,11,12,13,14]. Although the rate of ocular trauma in the patient group of our study differed between the pediatric and adolescent groups, it was more common in males, generally 1.3:1.
Ocular traumas constitute 5% of all cases in developed countries and approximately 12.9% in developing countries . Although the incidence was not reported in a study by Dandona et al., they reported that ocular trauma constituted 4.2–7% of all childhood blindness . In our study, the incidence of pediatric ocular trauma was found to be 0.72%; the pediatric ocular trauma-related blindness rate was found to be 2.47% in a 1-year period. The differences in the incidence of ocular trauma in the pediatric population may be due to the overuse of emergency services in our country and the lower incidence. In addition, sociocultural differences may be another factor contributing to this difference.
In a study, it was reported that most of the children presenting with ocular trauma resided in urban areas (70%) . Although our hospital accepts patients from every region of the city and rural areas; it has been determined that the admissions are mostly from the city center and in places and times where parental supervision is reduced. It should not be ignored that the differences in the rural and urban populations may be due to the conditions that restrict access to treatment in rural areas.
We found that children aged 7–11 years (66.83%) were most affected, followed by those aged 0–6 years (19.31%). In a study conducted in Kuwait, the average age was 7.8 years; in our study, the average age was 8.9 years, similarly. In a case series conducted in Denmark, the mean age was 13 years . They stated that this may be due to the fact that the 13–18 age group is more frequently engaged in individual entertainment, games, and activities.
In this study, we determined that toys were the main cause of ocular injury in the 0–6 age group, as in studies conducted in other countries. Pencils were the main cause in 7–12 age group; sports activities were the main cause in 13–18 age group. In our study, similar to previous studies, 33% of the injuries were caused by active fireworks . In another study, despite the fireworks regulation law, it has been reported that eye injuries are on the rise, especially in relation to the increased use of fireworks during festivals . Similarly, in our study, injuries related to the use of fireworks in weddings and celebrations, which increased in the summer months, were more common. Safety glasses should be worn during risky activities. Sharp objects such as pens, scissors, needles, knives, and household chemicals such as acid should be out of the reach of children. Strict laws and family and community education are urgently needed to stop injuries related to fireworks.
As a result of our study, contrary to studies conducted in developing countries, open globe injuries (40.59%) were found to be lower than closed globe injuries (59.41%) . In our opinion, this difference is due to the fact that the patients are frequently in the older age groups that can protect themselves better than the younger age group.
In this study, we noticed that the emergency department physicians did not inform the patients and families about ocular trauma and prevention methods, and even if they did, they did not write this in the patient’s medical records. Emergency department doctors can play an important role in preventing ocular trauma. They can inform patients and their families about what to do when an ocular injury occurs and what precautions can be taken before it happens.