Pediatric lens trauma in Tanta University eye hospital

Background: Lens trauma is commonly found among school-children (mainly boys) aged 5-15 years. The timing of surgery is important for visual rehabilitation, it is also important to consider in a child, in whom amblyopia is a concern. Ultrasound Biomicroscopy (UBM) can be used as an effective diagnostic tool. The biometry of the anterior segment can be measured by UBM systems that encompass the entire anterior segment. This allows preoperative evaluation of the position of the sulcus plane before cataract surgery, facilitating estimation of postoperative intraocular lens position. Aim of the Work: The purpose of the current work is to investigate the causes, clinical aspects and outcome of pediatric lens trauma. Patients and Methods: This prospective, randomized study included 40 eyes of 40 patients with eye trauma coming to Tanta University Eye Hospital. During the period from September 2018 to August 2019. Their age ranged between 2 to 18 years old. All patients in this study subjected to the following: Full history taking, general examinations and precautions if polytrauma, full ophthalmic examination. Investigation were done if indicated (Orbital imaging, Ultrasound Biomicroscopy) and examination of the contralateral eye. Results: Our prospective study included 40 eyes of 40 patients with eye trauma (25 males and 15 females). The majority of our patients (67.5%) were more than 6 years. The most prevalent cause was blunt trauma which represented 62.5%. Ocular trauma in street was the most prevalent site (50%). Early detection and seeking medical advice for ocular trauma represented 62.5% of cases. Right eye was affected in 22 (55%) patients. 85% of our patients had rupture globe and 15% of patients had closed globe lesions. 70% of cases had 2 sessions of surgery. By using UBM to evaluate the cases, most of cases (42.5%) had cataract, followed by rupture of posterior capsule which was found in 8 cases. With slit lamp examination, the most prevalent status of the lens was cataract in 52% of patients, then free lens matter in anterior chamber and clear lens with the same percentage (12.5% of patients). There was a statistically significance difference between lens examination by slit lamp and UBM (P= 0.032) and there wasn’t a statistically significance between AC examination by slit lamp and UBM. There wasn’t a statistically significance association between the causative agents and both of the type of injury and the number of surgery sessions. Also there wasn’t a statistically significance with place of trauma. While There was a statistically significance association between time of presentation and type of injury p = 0.001. Conclusion: This study reported maximum incidence of paediatric ocular trauma at school age children with blunt objects as the most common cause of injury. UBM is a very helpful tool in assessment of lens status after trauma also in decision making for surgery.