Penetrating needle injury of the eye causing cataract in children

Peter K Rabiah MD

Purpose: To review the presentation, management, and outcome of children with cataract caused by ocular needle penetration.

Design: Retrospective, non-comparative interventional case series.

Participants: Forty-two children with cataract caused by ocular needle penetration.

Intervention: Cataract surgery.

Main outcome measures: Best-corrected post-operative visual acuity.

Results: Injuries were unintentional and occurred during unsupervised play. The type of needle involved was hypodermic in 24 cases, sewing in 7, and undetermined in 11. Endophthalmitis developed in 14 cases and retinal detachment in 6. Endophthalmitis occurred in 12 cases (50%) of hypodermic needle injury but in no case of sewing needle injury. With a mean postoperative follow-up of 2.3 years, the best-corrected visual acuity was 20/40 or better in 19 cases, 20/50 to 20/80 in 7, 20/100 to counting fingers in 6, light perception in 1, no light perception in 6, and undetermined in 3. Eyes with endophthalmitis and/or retinal detachment had a worse visual prognosis.

Conclusions: Ocular penetration causing cataract occurred in children during unsupervised play with inadequately stored or disposed of hypodermic or sewing needles. Endophthalmitis occurred frequently in injuries caused by hypodermic needles but not in those caused by sewing needles. Visual outcome after management was good in approximately half of the cases especially if endophthalmitis or retinal detachment did not develop.

Published courtesy of: Ophthalmology 2003; 110: 173-176