From the Guidelines
Common Ocular Emergencies in Pediatric Patients
Ocular emergencies in children require prompt evaluation and treatment to prevent vision loss and long-term complications. The most common ocular emergencies in pediatric patients include traumatic injuries, such as orbital fractures and open globe injuries, which can result in vision loss, diplopia, and restriction of ocular movement 1.
Causes and Signs of Orbital Injuries
The most common causes of pediatric orbital fractures are motor vehicle collisions, sports injuries, falls, and assault 1. Signs of orbital injuries include periorbital soft tissue swelling, ecchymosis, hyphemia, subconjunctival hemorrhage, diplopia, restriction of ocular movement, or vision loss.
Other Ocular Emergencies
Other ocular emergencies in children include chemical exposure, which requires immediate irrigation with saline solution for at least 20 minutes, followed by administration of topical anesthetics such as proparacaine 0.5% or tetracaine 0.5% for pain relief. Corneal abrasions can be treated with antibiotic ointments like erythromycin 0.5% or bacitracin 0.5% applied four times daily for 3-5 days. In cases of suspected retinal detachment, intravenous acetazolamide 10-20 mg/kg may be administered to reduce intraocular pressure.
Importance of Prompt Evaluation and Treatment
Prompt evaluation and treatment of ocular emergencies in children are crucial to prevent vision loss and long-term complications. Regular vision screening is also essential to detect amblyopia and other vision problems early, as treatment can improve visual acuity and reduce the risk of permanent vision loss 1.
Key Points
- Traumatic injuries are a common cause of ocular emergencies in children
- Prompt evaluation and treatment are crucial to prevent vision loss and long-term complications
- Regular vision screening is essential to detect amblyopia and other vision problems early
- Treatment of ocular emergencies, such as chemical exposure and corneal abrasions, requires immediate attention and appropriate management.
From the Research
Common Ocular Emergencies in Pediatric Patients
- Traumatic injury 2
- Allergic conjunctivitis 2
- Infectious conjunctivitis 2
- Chalazion/blepharitis 2
- Amblyopia, which is the leading cause of monocular vision loss in children 3
Vision-Threatening Eye Emergencies
- Blunt ocular trauma 4, 5
- Chemical ocular injury 4, 5
- Orbital cellulitis 4, 5
- Endophthalmitis 4
- Acute angle closure glaucoma 4, 5
- Optic neuritis 4
- Giant cell arteritis 4
- Central retinal artery occlusion 4
- Retinal detachment 4, 5
- Homonymous hemianopia 4
- Vision loss, which may represent vascular occlusion and should be evaluated promptly by an ophthalmologist 5
- Floaters and flashes, which may represent vitreous or retinal detachment and should be evaluated by an ophthalmologist 5, 6