Characteristics, Etiological Factors, and Visual Outcomes of Pediatric Open Globe Injuries in Central Saudi Arabia: A 22-Year Retrospective Study

PURPOSE: To discuss the characteristics, etiological factors, and visual outcomes of open globe injuries (OGIs) in children at a tertiary eye hospital in Riyadh, Central Saudi Arabia. METHODS: This was a hospital-based cohort study conducted in 2021. Children aged ≤16 years with OGI based on the Birmingham Eye Trauma Terminology classification were included. The age, gender, type, cause of OGI, and vision were recorded, as well as uncorrected and best corrected visual acuity (UCVA and BCVA, respectively). There was a change in the UCVA and BCVA one year after management. BCVA following management was linked to a variety of factors. RESULTS: There were 664 eyes with OGI. [median age 5.1, 461 (69.6%) boys]. UCVA at presentation was <20/400 in 525 (79%) of eyes with OGI. Injuries were mainly due to metallic objects in 195 (29.4%), glass in 102 (15.4%), and fireworks in 62 (9.4%). The Change in visual impairment grade in UCVA and BCVA after management compared to the initial presentation was significant (p < 0.001). Improvement of two lines of BCVA was noted in 345 (52%), no change in (<± 2 lines) 299 (45%) and deteriorated in 10 (1.5%). CONCLUSION: OGI was identified as a leading cause of unilateral blindness. Children with OGIs who receive standard treatment have better outcomes. Many children could not achieve normal, functional vision despite the intervention of skilled care providers.