Trends in pediatric ocular trauma presenting to an ophthalmology-specific emergency department during the COVID-19 pandemic

Cavuoto, Kara M.; Osigian, Carla J.

Introduction: The home environment is the most common setting for eye injuries in children.[1,2] As children remained at home throughout the COVID-19 pandemic due to ‘Stay at Home’ orders and mandated school closures, the potential for ocular injury was increased. We describe the trends in ocular trauma in children presenting to an ophthalmology emergency department (ED) during the COVID-19 pandemic. Methods: Retrospective review of children (≤18 years old) presenting to an ophthalmology ED from March 1 to August 31, 2020. Results: Children represented 6% (643) of 10,738 ED patients. Of these, 156 (24%) sustained ocular trauma. Although the overall number of visits decreased by 44% compared to the same 6-month period in 2019, trauma-related visits were only 34% lower. Most visits occurred in March (32%) and August (17%). Over half (57%) were male with a mean age of 8.9 ± 1.4 years. Most patients ranged between 1-6 (39%) and 13-18 (32%) years old. There was no difference in average age by month (p = 0.71). The majority of visits were due to closed globe trauma (94%), which occurred due to blunt (49%) or sharp (14%) objects, foreign bodies (23%), or chemical injuries (14%). Ten (6%) patients presented with an open globe. There were no other significant differences among average ages by diagnosis, however chemical injuries tended to occur in younger patients (4.7 ± 4.6 years) compared to all other diagnosis groups (9.7 ± 5.4 years;P = 0.0002). Conclusion/Relevance: Although COVID-19 restrictions limited school, recreational activities and team sports, ocular injuries remained prevalent in children during the pandemic. Blunt trauma was most common regardless of age, however chemical injuries occurred predominantly in children <6 years old.