Characteristics of open globe injury in a pediatric population at an ophthalmology center in Mexico City
Oscar Francisco Miranda-Gómez, Claudia Patricia Alonzo-Correa, Priscila Verduzco-Martínez, Giovanna Elizabeth Enriquez-VeraAbstract
Introduction:
Open globe injury (OGI) is an ophthalmological emergency involving a full-thickness breach of the eye wall and represents a preventable cause of visual impairment, particularly in the pediatric population. Despite its clinical significance, there are limited epidemiological reports in Mexico describing its clinical characteristics, associated mechanisms, and visual outcomes.
Objective:
The objective is to describe the clinical-epidemiological profile, anatomical lesion characteristics, therapeutic management, and visual outcomes in pediatric patients with OGI treated at a tertiary referral ophthalmology center in Mexico City.
Materials and Methods:
A retrospective and observational study was conducted, including 111 patients between 2017 and 2024. Demographic variables, injury type, affected anatomical zone, initial and final visual acuity, presence of intraocular foreign bodies, administered treatments, and posttraumatic complications were analyzed. Quantitative variables were reported using the median values and interquartile ranges (IQR).
Results:
A total of 111 cases were included, with a median age of 8 years; 73.9% were male. Penetrating injuries accounted for 85.6% of cases and the left eye was affected in 58.6%. Zone 1 was the most frequently compromised (48.7%). The most common causative objects were wood/vegetable matter (19.8%), glass (17.1%), and stone (10.8%). The median initial visual acuity was 2.70 logMAR (IQR 1.80–3.70), improving to a final median of 0.88 logMAR (IQR 0.28–2.09), with visual improvement observed in 76.8% of patients. The most common associated lesions were corneal laceration (91.0%), iris prolapse (67.6%), and traumatic cataract (56.8%). Follow-up complications included corneal scarring (36.7%) and retinal detachment (19.4%). Only one case resulted in the loss of the eyeball.
Conclusions:
Pediatric OGI predominantly affected school-aged males, typically involving penetrating mechanisms occurring within the home environment. Early surgical intervention facilitated anatomical preservation of the globe in 99% of cases and led to significant visual improvement in the majority. These results constitute the first national record of its kind, providing key evidence for the development of preventive strategies and targeted care for the pediatric population in Mexico.