Corneal abrasions in young infants

We sought to determine the prevalence of corneal abrasions and possible associations with fingernail length, demographic information, sleeping, and crying among young infants. Parents of 1- to 12-week-old infants without symptoms who were presenting for well-child visits completed a brief questionna...

Full description

Saved in:
Bibliographic Details
Published in:Pediatrics (Evanston) 2010-03, Vol.125 (3), p.e565-e569
Main Authors: Shope, Timothy R, Rieg, Thomas S, Kathiria, Nazima N
Format: Article
Language:English
Subjects:
Babies
Cornea
Corneal Injuries
Crying
Eye Injuries - epidemiology
Eye Injuries - etiology
Eyes & eyesight
Female
Humans
Infant
Infant, Newborn
Male
Nails
Ophthalmology
Pediatrics
Prevalence
Regression analysis
Wound healing
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We sought to determine the prevalence of corneal abrasions and possible associations with fingernail length, demographic information, sleeping, and crying among young infants. Parents of 1- to 12-week-old infants without symptoms who were presenting for well-child visits completed a brief questionnaire on age, gender, race, fingernail-trimming practices, and sleeping and crying in the preceding 24-hour period. Fingernail length was measured, and eyes were examined through staining with fluorescein and illumination/magnification with a Bluminator (Eidolon Optical, Natick, MA). Patients with corneal abrasions were given orally administered acetaminophen and erythromycin ointment. Masked interrater reliability for abrasions was measured. Logistic regression analyses determined the association of corneal abrasions with potential covariates. Ninety-six subjects were enrolled, including 47 girls (49%), with a mean age of 32.2 days (SD: 21.7 days). Forty-seven infants (49%) had abrasions. Demographic variables and mean crying times (114.8 +/- 124.9 vs 86.5 +/- 111.7 minutes; P < .24) were not significantly different for infants with and without abrasions. Infants with abrasions slept more (15.9 +/- 3.3 vs 14.5 +/- 3.6 hours; P = .054). Associations of fingernail-trimming method and fingernail length with corneal abrasions were not statistically significant. Masked interrater reliability was high, with agreement between the primary investigator and the associate investigator for 20 (91%) of 22 eyes and agreement between the primary investigator and a pediatric ophthalmologist for 9 (90%) of 10 eyes. Corneal abrasions are extremely common among 1- to 12-week-old infants and have unclear clinical significance. Primary care physicians should be careful about attributing unexplained persistent crying to corneal abrasions, potentially missing a more-serious problem.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2008-2023