[Factors associated with school aged children ages 4-12 in the kingdom of Bahrain]

by

Acknowledgement

I would take this opportunity to thank my research supervisor, family and friends for their support and guidance without which this research would not have been possible.

DECLARATION

I, [type your full first names and surname here], declare that the contents of this dissertation/thesis represent my own unaided work, and that the dissertation/thesis has not previously been submitted for academic examination towards any qualification. Furthermore, it represents my own opinions and not necessarily those of the University.

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Table of Contents

CHAPTER 2: LITERATURE REVIEW1

Introduction1

Mechanisms Of Ocular Trauma2

Blunt Injuries2

Penetrating Injuries6

Intra-Ocular Foreign Bodies7

Burns8

Management Of Injuries9

Changing Trends In The Pattern Of Ocular Injuries13

Eye Examination16

Diagnosis and Management17

Corneal Abrasions17

Foreign Bodies18

Chemical Burn19

Conjunctivitis20

Prevention22

Contact Lens Use22

In sports23

Sport Classification and Risk24

Preparticipation Examination25

Most Common Mechanisms of Eye Injuries25

Aspects of the Ocular Examination26

Protective Devices28

Functionally One-Eyed Athletes28

Return to Play29

Self Inflicted injuries29

Psychiatric theories32

Religious ideation32

Sexual ideation32

Biochemical theories33

Forms of self-inflicted eye injury35

Self-enucleation (oedipism)35

Management36

Orbital injuries38

Posterior segment injuries40

Epidemiology40

Classification42

Orbital trauma45

Globe trauma: anterior segment46

Globe trauma: posterior segment49

Neuro-ophthalmologic trauma51

Anesthesia management in ocular trauma52

Clinical presentation and assessment52

Eye trauma requiring immediate referral53

Ruptured globe53

Orbital floor fracture54

Penetrating trauma and intraocular foreign bodies54

Eyelid lacerations55

Chemical burns55

Eye trauma that can be managed in the GP surgery55

Corneal foreign bodies56

Corneal abrasions56

Arc eye56

Acute red eye requiring immediate referral57

Acute angle-closure glaucoma57

Keratitis58

Iritis (anterior uveitis)59

Scleritis59

Orbital cellulitis60

Endophthalmitis60

Acute red eye that can be managed in the GP surgery61

Conjunctivitis61

Subconjunctival haemorrhage62

Visual loss63

Central retinal vein occlusion63

Central retinal artery occlusion63

Temporal (giant cell) arteritis64

Optic neuritis65

Retinal detachment65

Vitreous haemorrhage66

Amaurosis fugax66

Blindness and visual impairments67

Corneal abrasion69

Description69

Causes and symptoms69

Diagnosis70

Treatment70

Prognosis70

Prevention71

CHAPTER 4: ANALYSIS72

Presentation Of Findings72

Analysis of the research questions72

Discussion89

CHAPTER 5: CONCLUSION AND RECOMMENDATION92

REFERENCES95

Chapter 2: Literature Review

Introduction

Annually, more than 500,000 eyes worldwide lose all vision1 and even more eyes lose partial vision as a result of ocular trauma. For children, ocular trauma is the leading cause of monocular blindness and results in long-term morbidity.

A population-based study estimated that, each year, 15.2 children per 100,000 in the United States suffer ocular trauma. The epidemiology of ocular trauma is time- and region-dependent, and trauma may be more common and more severe, and may have a poorer prognosis, in developing countries. Although the epidemiology of pediatric ocular trauma has been described for several western societies, including the United States, the United Kindom, and Australia, only one previous report described pediatric ocular trauma in east Asian populations. Therefore, the current study was conducted to increase knowledge about the epidemiology and clinical features of major ocular trauma in children, in the hopes that this knowledge will facilitate optimal treatment and help to decrease the incidence of pediatric eye injury in Bahrain and perhaps among other pediatric populations.

Ocular injuriesare common in children and may result in significant visual impairment and long-term detrimental effects on their well-being. These injuriesare also common in adults who have experienced severe trauma. Although the incidence of such injurieshas significantly decreased as a result of a variety of legislation (eg, dictating seat belt use and type of automobile glass), severe ocular traumastill occurs.

There is little information regarding the specific details of ocular injuriesin children after major trauma.

Approximately half of all patients who present to an eye casualty ...