Case 4: Zone I Pediatric Open Globe Management

A 4-year-old boy presented with a Zone I open globe injury of the left eye. The child was playing with other children at a campground when he was hit directly in the left eye by a wooden stick. The patient was seen at another hospital and transferred to Massachusetts Eye & Ear (MEE) due to concern for open-globe injury. On presentation, the patient was found to have a large, vertical, corneal laceration extending from 12 to 6:30 o’clock with iris prolapse and concern for possible lens violation. The patient was taken to the operating room for exploration and repair of his corneal laceration. During the post-operative period, vision gradually improved, and the lens capsule was noted to be intact. A small posterior subcapsular cataract was noted in the initial post-operative period. Sutures were removed intraoperatively after 1 month due to faster wound healing in most children compared to adults, and the vision continued to improve. The patient followed up with a pediatric and corneal specialist closer to home and continued standard amblyopia therapy with good results.