Diabetic Macular Edema - Diagnostics and Treatment Guidelines.

Together with diabetic retinopathy, diabetic macular edema (DME) ranks among the most common causes of severe loss of vision in working adults. Due to recent developments in imaging methods, new classification schemes of DME have been created. In addition to this, new treatment options have been introduced (new intravitreal drugs as well as treatment protocols). At the same time laser, surgical as well as combination therapy is still available. In this paper we evaluate the current knowledge about DME diagnostic and treatment options and formulate recommended guidelines for the management of DME.

Diabetic Retinopathy ­ Diagnostics and Treatment Guidelines

Diabetic retinopathy is one of the most common complications of diabetes mellitus and represents a serious health, social and economic problem. With the expected increase in the number of patients with diabetes, it is becoming the leading cause of severe vision loss in the working-age population.  The presented guidelines summarize the current knowledge about this disease in order to standardize and update the procedures for the diagnosis, classification and treatment of diabetic retinopathy.

Diabetic Retinopathy and Diabetic Macular Edema - Screening.

Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of severe visual loss in the working population. Therefore, both DR and DME have a significant socioeconomic and health impact, which taking into account the epidemiologic predictions is expected to increase.  A crucial role in the management of DR and DME (not only for individuals, but also for the population) is played by an adequate screening program. This is based on the structure and organization of the healthcare system, the latest scientific developments in diagnostics (imaging) as well as technological advancements in computing (artificial intelligence, telemedicine) and their practical use. The recommendation presented by World Health Organization is also important. This paper evaluates all these factors, including evidence-based medicine reports and experience from existing DR and DME screening programs in comparable countries. Based on an evaluation of these parameters, recommended guidelines have been formulated for screening for DR and DME in the Czech Republic, including linkage to the Czech National Screening Center and the organization of the healthcare system.

EFFECT OF BASELINE CENTRAL RETINAL THICKNESS ON THE RESULTS OF TREATMENT OF DIABETIC MACULAR EDEMA WITH AFLIBERCEPT: REAL-LIFE EVIDENCE IN THE CZECH REPUBLIC.

AIM: Presentation of the 1-year results of aflibercept treatment in patients suffering from diabetic macular edema (DME) and comparison of the response to treatment of patients with different baseline central retinal thickness (CRT). METHODS: This was a multicentre, retrospective observational study of a series of cases. Patients with DME were treated in a fixed regimen (5 injections at 1-monthly intervals and then injections at 2-monthly intervals). The period of follow-up was 12 months. The development of best corrected visual acuity (BCVA) and CRT was evaluated. Measurements were performed prior to the commencement of treatment and then after 4, 6, 8, 10, and 12 months. RESULTS: The therapeutically naive group consisted of 82 eyes of 79 patients. The total cohort of patients was divided into 3 groups according to the baseline values of CRT. The first group was composed of 28 eyes with baseline CRT < 450 μm (34.1%), the second included 25 eyes with CRT in the range of 450-550 μm (30.5%), and the third group consisted of 29 eyes with baseline CRT > 550 μm (35.4%). The average baseline BCVA and SD in the first group was 66 ±7.1 letters ETDRS optotypes, and then 70 ±7 letters, 69.6 ±7.3 letters, and 71.3 ±7 letters at the follow-ups after 4, 8, and 12 months. The average baseline value of CRT and SD in the first group was 379 ±48.6 μm, and then 337.1 ±76.5 μm, 320.2 ±74.1 μm, and 315.1 ±62.2 μm after 4, 8, and 12 months. The average baseline BCVA and SD in the second group was 64.1 ±9.7 ETDRS letters, and then 66.9 ±10 letters, 70 ±9.9 letters, and 70.5 ±11.5 letters after 4, 8, and 12 months. The average baseline value of CRT and SD in the second group was 497.4 ±76.4 μm, and then 376.5 ±106.1 μm, 360.8 ±70 μm, and 351.3 ±91.3 μm after 4, 8, and 12 months. In the third group, the average baseline value of BCVA and SD was 59.7 ±10.4 ETDRS letters, and then 65 ±10.6 letters, 64.8 ±9.6 letters, and 67 ±10 letters after 4, 8, and 12 months. The average baseline value of CRT and SD in the third group was 639.4 ±79.6 μm, and then 396.7 ±147.1 μm, 416.9 ±139.8 μm, and 368.5 ±109.9 μm after 4, 8, and 12 months. All these changes were statistically significant (p < 0.05). CONCLUSION: Aflibercept treatment in a fixed regimen in patients suffering from DME results in a statistically significant improvement in BCVA and a decrease in CRT in the first year of treatment. Patients with a higher baseline CRT showed the best anatomical and functional results of the 1-year treatment with aflibercept.

Changes in tear film osmolarity after 25G+ PPV.

BACKGROUND: The aim of our study was to assess changes of tear film osmolarity after micro-incision 25G+ pars plana vitrectomy (PPV) in a prospective study. METHODS: The group consisted of 21 patients (17 women, 4 men) with an average age of 70,52 years [48; 85]. All patients underwent 25G + PPV surgery due to a disorder of the vitreomacular interface (macular hole or epimacular membrane). Only patients who did not use artificial tears before the surgery and who had not been diagnosed with dry eye syndrome at ours or another institution were included in the study. Except cataract surgery, all ocular surface diseases, intraocular diseases, trauma or surgery were exclusion criterias. Tear film osmolarity was measured in both eyes in every patient before surgery, 10 days after surgery and 30 days after surgery. A paired test was used for statistical evaluation. RESULTS: No statistically significant change in osmolarity was found in the operated eyes (p > 0.05). No statistically significant changes in time (p > 0.05) were found when both eyes were compared. There were no postoperative complications or failure to observe the study protocol. CONCLUSION: Micro-incision 25G + PPV does not affect the osmolarity of the tear film.

TRAUMA IN OCULOPLASTIC SURGERY A REVIEW.

The aim of this article is to present the basics of traumatology in oculoplastic surgery and to review the literature about this topic. This review sums up the problematic of injuries of the eyelid, lacrimal system and orbit. The most important types of trauma, their treatment options, and the most common complications are described. In majority of oculoplastic traumas, surgical reconstruction is the treatment of choice. The surgery is often performer immediately, but sometimes the reconstruction of eyelid and lacrimal injuries can be postponed up to 48 hours, if the immediate surgery is not possible. Although the recommendations from the literature on this topic are variable, most of the patients require at least local antibiotics, more complex traumas systemic antibiotics. Careful diagnostics and correctly performed surgical treatment, either only by ophthalmologist, or oculoplastic surgeon, or a multi-disciplinary team for more complex injuries, are the key to good functional and aesthetic results of the reconstruction.

Surgical Treatment of Idiopathic Macular Hole Using Different Types of Tamponades and Different Postoperative Positioning Regimens.

PURPOSE: To compare the effect of different types of intraocular tamponade and different types of postoperative positioning on the closure of idiopathic macular hole (IMH). METHODS: Prospective randomized clinical trial enrolling 104 eyes of 100 patients (age, 57-87 years) undergoing MH surgery. All patients were operated on by an experienced surgeon using 25-gauge pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling. Patients were randomized according to the type of intraocular tamponade and postoperative positioning into the following four groups: SF6 + nonsupine reading position (n = 26) (group 1), air + nonsupine reading position (n = 25) (group 2), air + prone position (n = 26) (group 3), or SF6 + prone position (n = 27) (group 4). The follow-up period was 6 months. RESULTS: MH closure was achieved in 87 eyes (83.7 %) in the overall sample after the first surgery, with closure rates of 100%, 56%, 84.6%, and 92.6% in groups 1, 2, 3, and 4, respectively. The group 2 was significantly less successful compared to the other three groups (p < 0.05). MH of sizes ≤400 µm was closed in 97.2% of cases after the first surgery, with no significant differences between groups (p = 0.219). MH with sizes over 400 µm was closed in 70.9% of cases after the first surgery, with both groups with air tamponade being significantly less successful than group 1. The nonsupine reading position was subjected to a better subjective evaluation in terms of postoperative comfort and quality of sleep, with no differences between air and SF6 tamponade tolerance. CONCLUSION: PPV with ILM peeling, intraocular tamponade, and positioning remains the basic surgical approach in the treatment of IMH. For MH ≤ 400 µm, a high closure rate can be achieved by combining air tamponade and nonsupine reading position. For macular holes >400 µm, the greatest anatomical success can be achieved by using the SF6 tamponade in combination with the nonsupine reading position.

Ocular Manifestations in Patients with HIV infection.

BACKGROUND AND AIMS: To evaluate the characteristics and incidence of ophthalmic manifestations in patients with HIV (Human Immunodeficiency Virus) infection. MATERIALS AND METHODS: A retrospective evaluation of medical records of 147 patients with HIV infection (22 female, 125 male), the average age of 41 (range 22-79 years) examined by an ophthalmologist at the Clinic of Ophthalmology at the University Hospital Ostrava in years 1987 - 2015. RESULTS: Ophthalmic manifestations of HIV were observed in 16 patients (11.9 %). There was not observed ocular involvement in patients in asymptomatic stage of HIV infection. Ophthalmic complications were observed in 1 patients (0.7 %) in early symptomatic stage and 15 patients (10.2 %) with stage AIDS (Acquired Immune Deficiency Syndrome). The most frequent ocular symptoms were caused by the virus (HIV retinopathy, mikroangiopathy) - total of 13 infected (76.5 %). Three patients had opportunity infections (17.6 %). As a result of the underlying AIDS disease 5 patients died. Ocular findings were observed at 2 of those (40.0 %). CONCLUSION: Ocular manifestation are common finding in late stages of HIV infection. Ophthalmic examination is an integral part of the diagnostic algorithm of patients with HIV infection. Most frequently, ocular symptoms have been found within the group of patients with advanced part of disease, which is in relation with the body´s immune defense decrease thus death itself.

[Cheek-midface lift for revision following failed excessive lower eyelid blepharoplasty]. / Wangen-Mittelgesichts-Anhebung zur Revision nach unsachgemäß exzessiver Unterlidblepharoplastik.

Iatrogenic ectropion with sagging of the lower eyelid after failed excessive lower eyelid blepharoplasty is a severe complication in aesthetic surgery. Traditionally, free skin grafting is the method of choice for correction. This overview presents the cheek-midface lift as a useful and powerful method for the correction of ectropion following excessive lower eyelid blepharoplasty. This technique, which can be performed with the patient under local anesthesia, enables good functional as well as aesthetic outcomes.

Results of Treatment of Diabetic Retinopathy by the Laser System PASCAL.

PURPOSE: To evaluate anatomical, functional and clinical efficacy of the pattern scanning laser (PASCAL®) photocoagulation in patients with diabetic retinopathy. METHODS: The cohort included 91 eyes in 50 patients (average age 63 years, 24 men and 26 women) treated at the Clinic of Ophthalmology, Faculty Hospital Ostrava, from 2008 to 2013. All eyes showed the signs of diabetic retinopathy (20.9% of eyes - very severe non-proliferative diabetic retinopathy (NPDR), 79.1% of eyes - proliferative diabetic retinopathy (PDR)). All the eyes were "treatment naive". The average duration of diabetes was 18 years, average baseline HbA1c value was 8.2 %. Panretinal photocoagulation was performed with by the means of PASCAL photocoagulator - with patterns and short duration pulses. Best corrected visual acuity (BCVA), central retinal thickness (CRT), fundus photography, biomicroscopy and complications were evaluated during the minimum of 12 months follow-up period. Statistical analysis using Shapiro-Wilk a Friedman tests with p value less than 0.05 was done. RESULTS: Mean baseline BCVA was 0.13 logMAR. Values 0.12, 0.15 and 0.19 logMAR were observed in the follow-up intervals at the 4th, 6th and 12th month. At the 6th month visit all 91 eyes (100 %) were stabilized, and at the 12th month visit in 5 eyes (5.5 %) progression of the disease was observed. No complications were observed during the first 12 months follow up. CONCLUSION: Laser photocoagulation of the retina with the use of short pulse durations and patterns in patients with DR is an effective and safe method of treatment. Key words: diabetic retinopathy, laser photocoagulation, patterns, low time of impulse, Pascal.

Xerosis in Patient with Vitamin A Deficiency - a Case Report.

Xerosis is a corneal and ocular surface disease caused by vitamin A deficiency. It is a rare disease in developed countries, but in third world countries it is a common cause of blindness. We describe a typical xerosis in patient with vitamin A deficiency and long-term malnutrition and alcoholism in our case. In spite of initially serious presentation of the disease, the patients response to treatment was prompt and there was complete regression of the disease. Key words: xerosis, vitamin A deficiency.

Congenital central toxoplasmic chorioretinitis - case study.

Congenital toxoplasmosis is a globally spread infectious disease caused by transplacental transmission of an intracellular parasitic protozoan Toxoplasma gondii. The infection can cause serious multi-organ complications, and in the case of vertical transmission, can lead up to fetal death - depending on the stage of pregnancy at the time of infection and the overall condition of the mothers immune system. Chorioretinitis, hydrocephalus and intracranial calcifications are a typical triad of symptoms associated with the disease. Toxoplasmic chorioretinitis in particular is the most common ocular manifestation. If the central retina is affected, it can cause a severe impairment of central visual acuity or lead up to blindness in the child. Prenatal screening of this disease is presently voluntary in the Czech Republic. This article reports on a case study of a toxoplasmic chorioretinitis in a newborn child observed from the active stage and the development of the affected retina over time. Further is also reported on the diagnostics and the treatment of multi-organ complications which occurred in this patient. Ophthalmologic examination was performed after diagnosis of hydrocephalus, which revealed severe changes of retina. Hydrocephalus was then properly treated. An overview of the diagnostic and therapeutic methods and the screening options available in the Czech Republic compare with other countries is also presented in the report. Key words: congenital toxoplasmosis, chorioretinitis, multi-organ complications, screening, hydrocephalus.

Ophthalmic manifestations of acute leukaemias.

BACKGROUND AND AIMS: To determine the incidence of ocular pathological findings in a group of patients with acute leukemia. To define the predictive value of the presence of the ocular pathological findings. MATERIALS AND METHODS: Retrospective evaluation of a group of 67 patients with acute leukemia (age 1-75 years) examined at the Ophthalmology Clinic, Faculty Hospital Ostrava, from 2005 to 2014. RESULTS: Ocular pathological findings were found in 13 patients of the group (19.4 %) - 7 patients with acute myeloid leukemia (10.9 %) and 6 patients with acute lymphoblastic leukemia (8.5 %). 10 patients died due to of the underlying disease. Ocular pathological findings were found in 6 of them (60 %). A higher prognostic value was found in a group of patients with AML. CONCLUSION: Ophthalmology examination is a necessary part of the examination of patients with acute leukemia. This prognostic benefit is particularly significant in patients with AML. Key words: acute myeloid leukemia, fundus leucaemicus, Roth's spot, ophthalmology examination.

[One-day simultaneous bilateral cataract surgery]. / Jednodenní oboustranná operace katarakty. Vlastní výsledky.

INTRODUCTION: Effectiveness Evaluation of One-Day Simultaneous Bilateral Cataract Surgery (SBCS) Comparing to the Cataract Surgery Performed on Each Eye Separately After a Lapse of Time. MATERIAL AND METHODS: The cohort of 100 patients (200 eyes) consisted of two groups: In the Group1, there were 50 patients (100 eyes) who underwent One-day Simultaneous Bilateral Cataract Surgery (SBCS). The Group 2 consisted 50 patients (100 eyes) who had the surgery on one eye first, and later on the fellow eye. The course of the surgery, peroperative and postoperative complications were evaluated. The patients from the Group 1 were examined at the first postoperative day. In the next course, all patients were examined one week, one month, and 3 months after the surgery. In the postoperative phase were, besides the complications, the final visual acuity and refraction and its deviations from the target refraction followed up. RESULTS: Course of the surgery, peroperative and postoperative complications are comparable in both groups. Endophthalmitis, or other more serious postoperative complications did not appear in either group. Three months after the surgery, the uncorrected visual acuity (UCVA) 0.8 and better in the Group 1 had 75 % of patients, and in the Group 2 also 75 % of patients. The UCVA 0.5 and better in the Group 1 had 95 % of patients; in the Group 2 it had 90 % of patients. The best-corrected visual acuity 0.8 and better had in both groups 95 % of patients. The final refraction after 3 months in the Group 1 was -0.15 ± 0.91 (-0.12); -3.37; 2.00. In the Group 2 the final refraction after 3 months was -0.08 ± 0.91 (0.00); -3.25; 2.75. CONCLUSION: The results are showing that both groups of our cohort are comparable. The One-Day Simultaneous Bilateral Cataract Surgery (SBCS) is, from the surgical point of view, equally safe and effective as classically performed cataract surgery.Key words: One-Day Simultaneous Bilateral Cataract Surgery (SBCS), refraction, visual acuity, postoperative complications, intraocular pressure.

[Treatment Results of the Diabetic Macular Edema by Means of the PASCAL Laser System]. / Výsledky lécby diabetického makulárního edému laserovým systémem PASCAL.

OBJECTIVE: To evaluate functional, anatomical and clinical efficacy, and safety of the pattern scanning laser (PASCAL®) photocoagulation in patients with diabetic macular edema and absence of proliferative diabetic retinopathy. METHODS: From 2008 to 2013 84 eyes of 58 patients (30 men, 28 women) were treated with pattern laser photocoagulation at the Ophthalmology Department at University Hospital Ostrava. Average age at the baseline visit was 65 years. The inclusion criteria included nonproliferative diabetic retinopathy (84 eyes), focal DME (14 eyes), diffuse exudative DME (70 eyes). All the eyes were "treatment naive". The average duration of diabetes was 18 years, average baseline HbA1c value was 8,4%. Either focal laser photocoagulation or grid photocoagulation was performed with the PASCAL photocoagulator. Best corrected visual acuity (BCVA), central retinal thickness (CRT), fundus photography, biomicroscopy and complications were evaluated during the minimum 12months follow-up period. Statistical analysis using parametrical and nonparametrical tests with p less than 0,05 was done. RESULTS: Mean baseline BCVA was 0,43 logMAR. Values 0,38, 0,37, 0,38 a 0,38 logMAR were observed in the follow-up intervals in the 4th, 6th, 12th and 18th month. In 4 eyes (5%) improvement of more than 3 lines was observed, in 26 eyes (31%) improvement from 0 to 3 lines was observed, in 52 eyes (62%) decrease from 0 to 3 lines was observed and in 2 eyes (2%) decrease of more than 3 lines was observed. Mean baseline CRT was 398 µm, values 370 µm, 362 µm, 349 µm and 338 µm were observed in the follow-up intervals in the 4th, 6th, 12th and 18th month. At the 12th month visit 76 eyes (90%) were stabilized, and in 8 eyes (10%) progression of the disease was observed. No complications were observed during the first 12 monhts follow up. CONCLUSION: Pattern scanning laser photocoagulation of DME lead to BCVA and clinical stabilization. In addition to this, it lead to decrease of the CRT. The efficacy was comparable to traditional laser systems with no apparent benefit to the traditional systems. The efficacy was inferior to modern intraocular anti-VEGF (vascular endothelial growth factor) drugs.

[Eye Myiasis - a Case Report]. / Ocní myiáza.

The authors describe a case of 47 years old patient who came to the department of ophthalmology with eye discomfort, ear bleeding and itching of both legs. The diagnosis of ophthalmomyiasis was made after an eye examination. Manual extraction of maggots from upper and lower fornix of the left eye was performed and symptomatic therapy was given. The patient was sent to otolaryngology and dermatology departments and MRI. The maggots were also found in both external auditory meatus and between the toes. MRI excluded affection of the deeper structures of the head. Improvement of the local condition was observed since the first follow-up visit.

[The cell phones as devices for the ocular fundus documentation]. / Mobilní telefony jako nástroj pro dokumentaci ocního pozadí

OBJECTIVE: To present our experience with "smart phones" when examining and documenting human eyes. METHODS: From September to October 2013 fifteen patients (8 men, 7 women) eye fundus was examined, an average age during the examination was 58 year (ranging from 20-65 years). The photo-documentation was performed with dilated pupils (tropicamid hydrochloridum 1% eye drops) with mobile phone Samsung Galaxy Nexus with the operating system Android 4.3 (Google Inc., Mountain View, CA, USA) and iPhone 4 with the operating system 7.0.4 (Apple Inc., Loop Cupertino, CA, USA), and with 20D lens (Volk Optical Inc., Mentor, OH, USA). RESULTS: The images of the retina taken with a mobile phone and the spherical lens are of a very good quality, precise and reproducible. Learning this technique is easy and fast, the learning curve is steep. CONCLUSION: Photo-documentation of retina with a mobile phone is a safe, time-saving, easy-to-learn technique, which may be used in a routine ophthalmologic practice. The main advantage of this technique is availability, small size and easy portability of the devices.

[Screening ROP in the University Hospital Ostrava]. / Screening ROP ve FN Ostrava.

OBJECTIVE: To analyze the group of premature infants who were examined by an ophthalmologist in screening for ROP (retinopathy of prematurity) at the University Hospital in Ostrava. METHODS: A retrospective observational case series. We reviewed and analyzed clinical records of all the premature infants born before the 32nd gestational week examined by ophthalmologist in ROP screening at the University Hospital in Ostrava in the period from 1. 9. 2011 to 31. 8. 2012. Childrens gestational age at birth, birth weight, postconceptional age (PCA) of the child at the time of the first ocular inspection, at the time of diagnosis ROP and at the time of any intervention, possible risk factors of ROP (Apgar score in the 1st minute, duration of oxygen therapy, FiO2 (%) (percentage fraction of oxygen in the inspired gas mixture), duration of mechanical ventilation, transfusion of erythrocytes (resuspended leukodepleted), presence of sepsis / infection in the perinatal period and duration of phototherapy) were evaluated. Eye examination was performed in local anesthesia with the use of an eyelid retractor, in artificial mydriasis, using an indirect ophthalmoscope and digital imaging system RetCam 3. RESULTS: 138 premature infants with an average gestational age at birth of 29.8 weeks, average birth weight 1385 g, were included in this study. Thirty-four children (24.6 %) were diagnosed with ROP, in all cases 1st stage at the time of diagnosis. An ophthalmologist indicated and subsequently implemented intervention (cryotherapy / laser treatment) in the case of five children (14.7 %) with ROP under general anesthesia. Average duration of oxygen therapy at infants with ROP was 371 hours, in the group without ROP 84 hours. The difference between the average values was statistically significant [t (37) = -3.69, P <= 0.0007]. Average time of mechanical ventilation in the case of children with ROP were 229 hours, in the group without ROP 41 hours [t (35) = -2.99, P <0.005]. In the case of children with ROP, we noticed on average 3 transfusions of erythrocytes, in the group without ROP 1 transfusion [t (40) = -3.94, P <= 0.0003]. The average value of the Apgar score in the 1st minute of children with ROP group was 6.3 and children without ROP 7.8. The difference between the average values of Apgar score in the 1st minute was between both groups statistically significant [t (136) = 4.06, P <= 0.00008]. Sepsis / infection in the perinatal period occurred in 30 (88.2 %) children with ROP, in comparison with 46 (44.2 %) children with sepsis / infection without ROP. Average duration of phototherapy in infants with ROP was 42.4 hours, in the group without ROP 53.6 hours [t(136) = 1,21, P<= 0,2]. CONCLUSION: This study demonstrated statistically significant correlation of Apgar score in the 1st minute, duration of oxygen therapy, duration of mechanical ventilation, transfusion of erythrocytes and presence of sepsis / infection on the onset and progression of ROP at premature infants in our group. No effect of FiO2 (%) and duration of phototherapy on the onset and progression of ROP was demonstrated.

[Ocular trauma in childhood at the University Hospital Ostrava in the years 2007-2011]. / Úrazy ocí a periokulární krajiny u detí ve FN Ostrava v letech 2007-2011.

OBJECTIVE: to investigate and analyze the group of child patients with ocular trauma in the Ostrava region in the Czech Republic. METHODS: A retrospective observational case series. We reviewed and analyzed clinical records of all the paediatric patients with ocular trauma treated at the University Hospital Ostrava in the years 2007 - 2011. Age, sex, mechanism of injury, type of ocular trauma, the consequences of injury and period of the year when the accident occurred were evaluated. BETT classification used in this study was modified and extended by chemical and thermal injuries and orbital trauma. Ocular burns, including thermal and chemical burns, were graded using the classification for ocular surface burns by Dua. RESULTS: 448 children (309 boys, 139 girls), aged from 3 months to 17 years (median 10 years) were included in this study. The most common ocular injury was closed globe injury (253 patients, 56,5 %), the next common were orbital injuries (149 patients, 33,3 %), burns injuries (39 patients, 8,7 %), the least frequent were open globe injuries (7 patients, 1,6 %). The most common mechanism of ocular trauma was hit by object (34,6 %), followed by trauma caused by blows and falls (15,2 %) and hit by another person (10,3 %). The 50,9 % of injuries occurred in days of school attendance. 10,3 % of injuries occurred directly at the school or preschool facilities. 6,5 % of the injuries were polytraumas, which required interdisciplinary cooperation. CONCLUSION: This study demonstrated that the incidence of eye injuries is greater in boys, mainly adolescents. Closed globe injuries are the predominant type of ocular trauma in childhood. The mechanism of ocular trauma is variable. Nonetheless there is a relation between the mechanism and the age of the child. Further research in terms of how the preventive measures would affect the incidence and severity of ocular trauma in children would be beneficial. The modified BETT classification of ocular trauma, including chemical and thermal injuries and orbital trauma may better address current requirements.