Child Abuse and the Eye in an African Population
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Purpose: There is a paucity of data on child abuse and the eye in West Africa. Therefore, a need exists to determinethe causes and circumstances surrounding these occurrences and their effects on the eye and visionin a pediatric population. Methods: A 3-year study of consecutive cases of ocular features that presented to an eye clinic following ahistory suggestive of child abuse along with any associated eye injury was carried out. Socio-demographiccharacteristics were obtained, as were the presenting and posttreatment visual acuity, and a full clinical eyeexamination was also done. Results: Fifty-six children with 56 affected eyes were examined. The male to female ratio was 1.8 : 1; the meanage was 8.25 ± 3.5 years; and the subjects were predominately primary school children 30 (53.6%). The mostcommon ocular disorders were conjunctiva hyperemia (46.4%), corneal abrasion/ulcer (25.4%), hyphema/uveitis (42.9%), retinal detachment (7.1%), sclera rupture (7.1%), and globe perforation (21.4%). The intraocularpressure was raised in 17.9% of participants. Presenting versus posttreatment visual acuities showed normalvision in four (7.1%) vs. eighteen (32.1%), visual impairment in 12 (21.4%) vs. six (10.7%), severe visual impairmentin 20 (35.7%) vs. 12 (21.4%), and blindness in 12 (21.4%) vs. 14 (25%), p < 0.001. The most commoninjurious agents were canes (25.0%) and sticks (17.9%). The people who inflicted the injuries were parents/relatives (uncles) in 35.7% of cases and the children themselves (accidents) in 21.4% of cases. Circumstancespredisposing participants to eye injuries were child labor in 39.3% and beatings in 25.0%. Complications werecataracts (25.0%), corneal opacity (39.3%), and retinal detachment (7.1%). Conclusions: Injuries commonly resulted from canes and sticks used during beatings, as well as from childlabor, corporal punishment, accidents, and assaults. Legislation and laws need to be enacted to prevent negativepsychosocial and economic impacts on the child, family and country as a whole.
Abstract
Purpose: There is a paucity of data on child abuse and the eye in West Africa. Therefore, a need exists to determinethe causes and circumstances surrounding these occurrences and their effects on the eye and visionin a pediatric population. Methods: A 3-year study of consecutive cases of ocular features that presented to an eye clinic following ahistory suggestive of child abuse along with any associated eye injury was carried out. Socio-demographiccharacteristics were obtained, as were the presenting and posttreatment visual acuity, and a full clinical eyeexamination was also done. Results: Fifty-six children with 56 affected eyes were examined. The male to female ratio was 1.8 : 1; the meanage was 8.25 ± 3.5 years; and the subjects were predominately primary school children 30 (53.6%). The mostcommon ocular disorders were conjunctiva hyperemia (46.4%), corneal abrasion/ulcer (25.4%), hyphema/uveitis (42.9%), retinal detachment (7.1%), sclera rupture (7.1%), and globe perforation (21.4%). The intraocularpressure was raised in 17.9% of participants. Presenting versus posttreatment visual acuities showed normalvision in four (7.1%) vs. eighteen (32.1%), visual impairment in 12 (21.4%) vs. six (10.7%), severe visual impairmentin 20 (35.7%) vs. 12 (21.4%), and blindness in 12 (21.4%) vs. 14 (25%), p < 0.001. The most commoninjurious agents were canes (25.0%) and sticks (17.9%). The people who inflicted the injuries were parents/relatives (uncles) in 35.7% of cases and the children themselves (accidents) in 21.4% of cases. Circumstancespredisposing participants to eye injuries were child labor in 39.3% and beatings in 25.0%. Complications werecataracts (25.0%), corneal opacity (39.3%), and retinal detachment (7.1%). Conclusions: Injuries commonly resulted from canes and sticks used during beatings, as well as from childlabor, corporal punishment, accidents, and assaults. Legislation and laws need to be enacted to prevent negativepsychosocial and economic impacts on the child, family and country as a whole.
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