Multiple and complex eye injuries in children
DOI: 10.32364/2311-7729-2024-24-2-6
G.Sh. Arzhimatova1,2, O.V. Karaseva3, E.A. Koroleva3, G.M. Chernakova2
1Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
2S.P. Botkin City Clinical Hospital, Moscow, Russian Federation
3Research Institute for Children's Emergency Surgery and Trauma, Moscow,
Russian Federation
Aim: to identify the medical and epidemiological hallmarks of eye damage in children with complex and multiple injuries in a specialized surgical department.
Patients and Methods: this study included 403 children aged 1 month to 18 years with eye injuries associated with multiple or complex injuries of varying severity on the day before hospital admission. All children were admitted between 2014 and 2020. The following data were evaluated: patient's age, gender, severity of complex trauma based on the ISS score, cause of trauma, combination of anatomical areas involved.
Results: among children with mechanical complex eye injuries, 255 (63%) were boys and 148 (37%) were girls. The mean age of boys was 10.2±0.34 years, and the mean age of girls was 8.5±0.42 years. Furthermore, more than half (67.5%) of those included in the study were school-aged children and adolescents. The most common types of injuries were those resulting from falls from height, school, sports, gunshot/mine blast, and street incidents. In more than half of the children (n=227, 56.4%), orbital traumas affecting the walls and/or content were reported. The most common type of eye damage was a complex damage to the orbit and ocular adnexa (most often as a periorbital hematoma). The percentage of children with multiple fractures of the orbital walls increases with an increase in the severity of polytrauma.
Conclusions: children most often received mechanical complex eye injuries as a result of road traffic accidents. The percentage of children with minor, moderate, and severe complex injuries (assessed by the ISS) was 47.1%, 18.4%, and 33.5%, respectively. Orbital fractures are the most common surgical entities in children with complex mechanical eye injuries. Unilateral orbital fractures were diagnosed in 56.4% of cases, while bilateral orbital fractures were diagnosed in 17.9%. In the majority of instances, mechanical complex eye injuries are associated with traumatic brain injury (99%).
Keywords: complex eye injuries, multiple injury, combined injury, mechanical complex eye injury, orbital fracture, orbital injury, morbidity pattern, damage to eye.
For citation: Arzhimatova G.Sh., Karaseva O.V., Koroleva E.A., Chernakova G.M. Multiple and complex eye injuries in children. Russian Journal of Clinical Ophthalmology. 2024;24(2):78–82 (in Russ.). DOI: 10.32364/2311-7729-2024-24-2-6.
About the authors:
Gul'zhiyana Sh. Arzhimatova — C. Sc. (Med.), associate professor of the Department of Ophthalmology, Russian Medical Academy of Continuous Professional Education; 2/1, Barrikadnaya str., Moscow, 125993, Russian Federation; Head of the Moscow City Center, S.P. Botkin City Clinical Hospital; 5, 2nd Botkinskiy pass., Moscow, 125284, Russian Federation; ORCID iD 0000-0001-9080-3170.
Olga V. Karaseva — Dr. Sc. (Med.), pediatrician surgeon, Deputy Director for Scientific Work, Research Institute for Children's Emergency Surgery and Trauma; 22, Bol'shaya Polyanka str., Moscow, 119180, Russian Federation; ORCID iD 0000-0002-8709-8391.
Elena A. Koroleva — ophthalmologist of the Consultative and Diagnostic Department, Research Institute for Children's Emergency Surgery and Trauma; 22, Bol'shaya Polyanka str., Moscow, 119180, Russian Federation; ORCID iD 0000-0003-1379-7971.
Galina M. Chernakova — C. Sc. (Med.), associate professor of the Department of Ophthalmology, Head of the Polyclinics Department No. 2, Moscow City Center, S.P. Botkin City Clinical Hospital; 5, 2nd Botkinskiy pass., Moscow, 125284, Russian Federation; ORCID iD 0000-0002-9630-6076.
Contact information: Elena A. Koroleva, e-mail: elena_doc@mail.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 17.04.2024.
Revised 24.04.2024.
Accepted 30.04.2024.
2. Baker S.P., O'Neill B., Haddon W. et al. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187–195. DOI: 10.1097/00005373-197403000-00001.
3. Galvagno S.M., Massey M., Bouzat P. et al. Correlation between the revised trauma score and injury severity score: implications for prehospital trauma triage. Prehosp Emerg Care. 2019;23(2):263–270. DOI: 10.1080/10903127.2018.1489019.
4. Muhm M., Danko T., Winkler H., Ruffing T. Assessment of prehospital injury severity in children: challenge for emergency physicians (in German). Anaesthesist. 2013;62(5):380–388. DOI: 10.1007/s00101-013-2176-8.
5. Palmer C.S., Gabbe B.J., Cameron P.A. Defining major trauma using the 2008 Abbreviated Injury Scale. Injury. 2016;47(1):109–115. DOI: 10.1016/j.injury.2015.07.003.
6. Лебедев М.В., Оленникова М.М., Бахтурина Ю.А., Бахтурин Н.А. Частота и структура повреждения органа зрения при сочетанных травмах в дорожно-транспортных происшествиях. Вестник Российской Военно-медицинской академии. 2015;2:92–95.Lebedev M.V., Olennikova M.M., Bakhturina Yu.A., Bakhturin N.A. Frequency and structure of damage to the organ of vision in combined injuries in road traffic accidents. Bulletin of the Russian Military Medical Academy. 2015;2:92–95 (in Russ.).
7. Степанов А.В., Гундорова Р.А., Кваша О.И. и др. Сочетанная травма глаз в условиях экстремальных ситуаций. Медицина катастроф. 2011;1:39–40.Stepanov A.V., Gundorova R.A., Kvasha O.I. et al. Combined eye injury in extreme situations. Emergency Medicine. 2011;1:39–40 (in Russ.).
8. Монахов Б.В. Повреждения органа зрения при сочетанной и множественной травме: особенности диагностики и лечения. Медицина катастроф. 2008;2:22–23.Monakhov B.V. Damage to the organ of vision due to combined and multiple trauma: features of diagnosis and treatment. Emergency Medicine. 2008;2:22–23 (in Russ.).
9. Рабинович С.С., Турапов А.А. Сочетанные черепно-мозговые травмы: терминология, классификация, эпидемиология, структура. Вестник Новосибирского государственного университета. 2008;6(3–2):140–147.Rabinovich S.S., Turapov A.A. Combined traumatic brain injuries: terminology, classification, epidemiology, structure. Bulletin of Novosibirsk State University. 2008;6(3–2):140–147 (in Russ.).
10. Кутровская Н.Ю., Левченко О.В., Шалумов А.З. и др. Дистопия глазного яблока у больных с краниоорбитальными повреждениями в остром периоде черепно-мозговой травмы. Анналы пластической, реконструктивной и эстетической хирургии. 2011;4:16–22.Kutrovskaya N.Yu., Levchenko O.V., Shalumov A.Z. et al. Dystopia of the eyeball in patients with cranio-orbital injuries in the acute period of traumatic brain injury. Annals of plastic, reconstructive and aesthetic surgery. 2011;4:16–22 (in Russ.).
11. Мошетова Л.К., Кочергин С.А., Кутровская Н.Ю. и др. Офтальмологическая диагностика и лечение краниоорбитальных повреждений в остром периоде черепно-мозговой травмы. РМЖ. Клиническая офтальмология. 2009;10(3):89–93.Moshetova L.K., Kochergin S.A., Kutrovskaya N.Yu. and others. Ophthalmological diagnosis and treatment of cranio-orbital injuries in the acute period of traumatic brain injury. RMJ. Clinical ophthalmology. 2009;10(3):89–93 (in Russ.).
12. Абрамян С.В., Аржанцев А.П., Арутюнов А.С. и др. Челюстно-лицевая хирургия: национальное руководство. М.: ГЭОТАР-Медиа; 2019.Abramyan S.V., Arzhantsev A.P., Arutyunov A.S. et al. Maxillofacial surgery: national guidelines. M.: GEOTAR-Media; 2019 (in Russ.).
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