When Dogs Attack Kids, Eyes Are Often the Target

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CHICAGO — When children suffer eye injuries from dog bites, treatment often becomes complicated with multiple surgeries and long recovery periods, a researcher said at the the American Academy of Ophthalmology's annual meeting.

Half of kids treated for eye injuries associated with dog attacks required surgery, and 18 percent of these surgical patients had to return for additional procedures, reported Dr. Henry Chen of the University of Colorado in Denver.

Read this story on www.medpagetoday.com.

Chen and colleagues analyzed records of 537 pediatric patients treated for facial dog bites at The Children's Hospital in Denver from 2003 to 2008. The study compared treatments and outcomes in the 77 children who suffered eye injuries in these incidents with those of the kids with facial wounds not involving the eyes.

Chen told MedPage Today that the hospital is the major tertiary care center for pediatric patients in a multistate region, although he estimated that more than half the patients in the study came from the immediate Denver area. He said parents in central Denver often bring injured children directly to the hospital, whereas children from farther away are generally transferred from other hospitals.

Eyelids were damaged in all the children with eye injuries, Chen reported. Children more rarely suffered corneal damage or fractures in the bones surrounding the eye.

Mixed breeds were the most common attackers, followed by Labrador retrievers, German shepherds, and Rottweilers.

The mean age of children with eye injuries was 3.9, which was significantly younger than in patients without eye involvement.

A variety of complications were seen in the eye-injured patients, such as scarring and tear duct obstruction. Fifteen different types of revision procedures were required in the seven patients who needed additional surgery.

Chen said eye injuries were a marker of the severity of injury overall — children with eye injuries also had significantly more facial zones involved and a higher total number of lacerations — but their presence also added to the medical treatment the children required.

He said the take-home message for emergency room personnel was that significant ophthalmic injuries, requiring specialist attention, are a risk in children with facial dog bites.

"If there's any concern about lacerations around the eye, it would be prudent to call an ophthalmology consultation to evaluate and make sure there aren't these other associated injuries," Chen said.

Early attention from eye specialists could allow for definitive treatment the first time around without a need for later revision, he suggested.

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