External ocular trauma in instrumental and normal deliveries

Abstract

Objective: To compare the occurrence of external ocular trauma in instrumental and normal deliveries.

Design: Prospective controlled study.

Setting: University Hospital of Wales, Cardiff.

Subjects: 133 babies born consecutively with the use of forceps and 133 control babies born without instrumentation to women matched for parity.

Interventions: External ocular examination.

Main outcome measures: The presence within 24 h of birth of corneal oedema, corneal abrasion, conjunctival chemosis, subconjunctival haemorrhage and lid oedema.

Results: Lid oedema and multiple minor external ocular trauma occurred in 52 and 22 babies, respectively, in the instrumental delivery group and in 13 and 8 babies, respectively in the control group (P less than 0.001). Corneal abrasion occurred in two babies and corneal oedema in one baby after forceps delivery but in none of the control group. No more serious injuries occurred. All injuries resolved without long term sequelae.

Conclusion: The frequency of sight threatening corneal trauma in instrumental deliveries is low. Specialist ophthalmic screening of these babies is not justified.