Severe ocular injuries from pointed door handles in children

Objective: To report severe ocular injuries caused by pointed door handles in children. Design: Noncomparative, interventional, retrospective case series. Methods: Clinical records of 15 patients who sustained severe ocular injuries from door handles were reviewed for place of trauma, presenting symptoms and signs, surgical procedures performed, and final outcome. Main Outcome Measures: Trauma caused by complications from the door handle injury, such as loss of vision and ocular and adnexal injuries, and treatment rendered. Results: There were 12 boys and 3 girls with an average age of 7.8 years (range, 6-10 years). Place of trauma was at home in 12 children and in school in 3 children. Presenting visual acuity (VA) was 4/200 in 1 patient, light perception (LP) in 5 patients, and no light perception (NLP) in 9 patients. There were 9 eyelid or canalicular lacerations, 4 ruptured globes, and 14 optic nerve avulsions. All ruptured globes were repaired initially and eyelid and canalicular lacerations were repaired primarily within 24 hours of presentation. Average follow-up was 21 months (range, 1 month-8 years). Final VA was 20/30 in 1 patient, LP in 1 patient, and NLP in 13 patients. Eight eyes required enucleation for painful blind eye or to achieve optimal cosmesis. Conclusions. Pointed door handles installed at current heights may pose a significant risk of ocular and periocular injuries among young children. (c) 2005 by the American Academy of Ophthalmology.