Epidemiology of ocular trauma in Australia

US youth perspectives on eye trauma and eye protection

Eye injuries from sports, activities, and work are a leading cause of vision loss in youth. Most eye injuries can be prevented with protective eyewear. An open-ended survey on youth perspectives on eye trauma and protection was administered to the MyVoice Text Message Cohort of US youth ages 14-24 years. Qualitative, text message responses were coded using thematic analysis. The survey was distributed to 798 recipients; 641 (80.3%) responded. Many youth were concerned about the impact of excessive screen use (n = 278 [43.8%]) and sunlight or UV exposure (n = 239 [37.6%]) on their eye health. Fewer were concerned about injury from sports and activities (n = 115 [18.1%]) or job-related eye risks (n = 77 [12.1%]). The most common actions that youth took to protect their eyes included sun protection (eg, sunglasses; n = 300 [47.2%]), refractive correction (eg, glasses, contacts; n = 195 [30.7%]) and screen protection (eg, blue light blocking glasses; n = 159 [25.0%]). Fewer wore eye protection for sports or activities (n = 54 [8.5%]) or work (n = 41 [6.5%]). Youth concerns about eye injury from screens and sunlight are misaligned with the main causes of vision loss in this population, suggesting that public health education is needed to promote optimal eye safety.

Association Between Socioeconomic Deprivation and Orbital Trauma in a Hospital-Based Population

PURPOSE

To examine the association between area-level socioeconomic deprivation and orbital trauma among emergency ophthalmology consults.

METHODS

We conducted a cross-sectional study using 5-year Epic data for all hospital-based ophthalmology consults at the University of Maryland Medical System, and the Distressed Communities Index (DCI) data for area-level socioeconomic deprivation. We ran multivariable logistic regression models adjusting for age to compute odds ratios (OR) and 95% confidence intervals (CI) for the association between the DCI quintile 5 distressed score and orbital trauma.

RESULTS

A total of 3,811 cases of acute emergency consults were identified, of whom 750 (19.7%) had orbital trauma and 2,386 (62.6%) had other traumatic ocular emergencies. The odds of orbital trauma among people living in a distressed community were 0.59 (95% CI 0.46-0.76) times the odds for those living in a prosperous community. Among White subjects, the odds of orbital trauma for people living in a distressed community were 1.71 (95% CI 1.12-2.62) times the odds for those living in a prosperous community; among Black subjects, the OR was 0.47 (95% CI 0.30-0.75; p-interaction = 0.0001). Among women, the OR for orbital trauma among those living in a distressed community was 0.46 (95% CI 0.29-0.71); among men, the OR was 0.70 (95% CI 0.52-0.97; p-interaction = 0.03).

CONCLUSION

Overall, we found an inverse association between higher area-level socioeconomic deprivation and orbital trauma among both men and women. The association varied by race, such that there was an inverse association with higher deprivation among Black subjects in contrast to a positive association among White subjects.

Prevalence of anophthalmia etiological factors in patients treated in a reference center: A retrospective study

Background

Ocular prosthesis rehabilitation has an important social, psychological, esthetic, and functional role. Congenital factors, trauma, and tumors, among others, can cause anophthalmia, and it is essential to identify the etiology to guide its prevention and treatment.

Methods

The aim of this study was to retrospectively investigate the records of patients treated from 2013 to 2020 by the Oral and Maxillofacial Prosthesis Group, aiming to identify the prevalence of patients with anophthalmia and the etiology of their anophthalmia. After approval by the Human Research Ethics Committee, two calibrated researchers evaluated 520 records, identifying those from patients with anophthalmia. The inclusion criteria were records with complete and legible information from patients with anophthalmia and a description of their etiology. Descriptive statistics were performed, and etiological factors were categorized into trauma, congenital cause, end-stage eye disease, and tumor. Spearman's correlation was performed to verify the relation between gender and anophthalmia etiology, with a 5% significance level. Seventy-two records were included in the study.

Results

It was observed that 33.4% of patients were women and 66.6% were men. The etiologies were physical trauma (52.4%), tumor (21.8%), end-stage eye disease (16.6%), and congenital cause (9.2%), and there was no correlation between gender and these etiologies (p = .301).

Conclusion

Most of the cases identified were of traumatic origin, which allows the establishment of preventive and educational measures to avoid new cases of anophthalmia.

Open-Globe Injury Repairs in the American Academy of Ophthalmology IRIS® Registry 2014 - 2018: Incidence, Risk Factors, and Visual Outcomes

PURPOSE

To estimate incidence and evaluate demographic risk factors and visual acuity (VA) outcomes of open-globe injuries requiring surgical repair in the IRIS® Registry (Intelligent Research in Sight).

DESIGN

Retrospective cohort study.

PARTICIPANTS

Patients with open-globe injury repairs (OGRs) were identified by Current Procedural Terminology codes (65275, 65280, 65285, 65286, 65235, 65260, and 65265) from 2014 through 2018 in the IRIS Registry.

METHODS

Logistic regression models adjusting for age, sex, race, ethnicity, United States region, concurrent and subsequent surgeries, and baseline VA.

MAIN OUTCOME MEASURES

Outcomes included annual and 5-year incidence rates per 100 000 people and factors associated with OGR, VA better than 20/40, and VA of 20/200 or worse at final follow-up (3-12 months after OGR).

RESULTS

Thirteen thousand seven hundred sixty-six OGRs were identified; 5-year cumulative incidence was 28.0 per 100 000 patients. Open-globe repair was associated with age 21 to 40 years compared with younger than 21 years (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.5-1.7]), male sex (OR, 2.8; 95% CI, 2.7-2.9), Black versus White race (OR, 1.3; 95% CI, 1.2-1.4), Hispanic versus non-Hispanic ethnicity (OR, 1.7; 95% CI, 1.6-1.8), and South (OR, 1.4; 95% CI, 1.3-1.5) and West (OR, 1.3; 95% CI, 1.2-1.4) versus Midwest regions and associated inversely with Asian versus White race (OR, 0.6; 95% CI, 0.6-0.7). Visual acuity outcomes, analyzed in a subset of 2966 patients with VA data available, showed vision impairment (VA < 20/40) at final follow-up was associated with VA of 20/200 or worse at presentation (20/200 better than 20/40; OR, 11.1; 95% CI, 8.0-15.7), older age (e.g., > 80 years vs. < 21 years; OR, 5.8; 95% CI, 3.2-10.7), and Black versus White race (OR, 1.8; 95% CI, 1.3-2.6). Risk factors were similar for VA of 20/200 or worse after OGR. Among the 1063 patients undergoing OGR with VA of 20/200 or worse at presentation, VA did not improve to better than 20/200 at follow-up in 35% of patients (1063/2996).

CONCLUSIONS

Our findings bring to light racial disparities in risk of OGR and poor visual outcomes that warrant further exploration.

FINANCIAL DISCLOSURE(S)

Proprietary or commercial disclosure may be found after the references.

Application of Proteomics Analysis and Animal Models in Optic Nerve Injury Diseases

Optic nerve damage is a common cause of blindness. Optic nerve injury is often accompanied by fundus vascular disease, retinal ganglion cell apoptosis, and changes in retinal thickness. These changes can cause alterations in protein expression within neurons in the retina. Proteomics analysis offers conclusive evidence to decode a biological system. Furthermore, animal models of optic nerve injury made it possible to gain insight into pathological mechanisms, therapeutic targets, and effective treatment of such injuries. Proteomics takes the proteome as the research object and studies protein changes in cells and tissues. At present, a variety of proteomic analysis methods have been widely used in the research of optic nerve injury diseases. This review summarizes the application of proteomic research in optic nerve injury diseases and animal models of optic nerve injury. Additionally, differentially expressed proteins are summarized and analyzed. Various optic nerve injuries, including those associated with different etiologies, are discussed along with their potential therapeutic targets and future directions.

Ophthalmic trauma: the top 100 cited articles in Ophthalmology journals

OBJECTIVES

To analyze the top 100 cited papers on ophthalmic trauma.

METHODS

A literature search of Ophthalmology journals within the ISI Web of Science database for the most cited papers related to ophthalmic trauma.

RESULTS

The most cited articles were published between 1943 and 2013, the greatest number being published in 2000. Ophthalmology (45), Archives of Ophthalmology (17), and the American Journal of Ophthalmology (15) published most of the articles. The institutions with the highest number of publications were Wilmer Eye Institute (10) and Massachusetts Eye and Ear Infirmary (7). Sixty-seven percent of the articles originated from the USA. The most common type of trauma studied was non-open-globe injuries and the most frequent topic studied were pathological conditions secondary to trauma (34), particularly endophthalmitis (8), and optic neuropathy (6). Articles presenting a standardized classification system for eye injury received the highest average of citations per publication. Types of research most frequently cited were observational clinical studies (62) and epidemiological studies (30); the least frequent were clinical trials (2).

CONCLUSION

This bibliographic study provides a historical perspective of the literature and identifies trends within the most highly influential papers on ophthalmic trauma. Many of these articles emerged within the past three decades and came from Ophthalmology journals that remain high impact to this day. Clinical trials have been difficult to conduct and are lacking, reflecting a critical need in ophthalmic trauma research, as most of our understanding of ophthalmic trauma comes from observational and epidemiological studies.

The epidemiology of eye injuries in Western Australia: a retrospective 10-year study

CLINICAL RELEVANCE

Eye injuries constitute a significant cause of preventable lifelong visual impairment or blindness. It is important to identify the context in which these injuries occur to develop intervention programs to reduce the incidence and severity of injury.

BACKGROUND

To evaluate the nature, external cause, place of occurrence and incidence rate of eye injuries treated at hospitals in Western Australia.

METHODS

Retrospective, population-based study of patients presenting to all emergency departments or admitted to hospital with primary or secondary eye injuries between 2005 and 2014.

RESULTS

The combined incidence rate of eye injuries requiring tertiary care was 278 per 100 000 person-years (95% CI 276-280). Significantly more males (79%, 44 569) presented to emergency departments (p < 0.001), and most injuries involved the cornea and conjunctiva (83%). The injury incidence rate was 248 per 100 000 person-years (95% CI 246-250). A total of 2823 and 3951 individuals were admitted to hospital for a primary or secondary eye injury, respectively. The most frequent primary diagnosis on admission was contusion (19%). Assault (24%) was the most common cause of injury requiring inpatient treatment. Indigenous individuals were hospitalised for an eye injury at a rate of 109 per 100 000 person-years (95% CI 102-116), compared to 27 (95% CI 26-27) for non-Indigenous individuals. Each year was associated with an increase in the mean number of eye injuries (7% and 5% for emergency department and hospital admission data, respectively).

CONCLUSION

Indigenous individuals and males experience eye injuries requiring tertiary management disproportionately. Indigenous female patients were conspicuously affected by eye injuries. Remedial intervention strategies should incorporate violence prevention as assault is a significant cause of eye injury.

Prevalence of ocular trauma in 6-12-year-old children living in Shahroud, Iran

Aim

To determine the prevalence of ocular trauma in Iranian children aged 6–12 years.

Methods

This population-based cross-sectional study, comprised the first phase of the Shahroud Schoolchildren Eye Cohort Study on primary school children using cluster sampling in urban areas and census in rural areas. The students underwent the measurement of uncorrected and corrected visual acuity as well as non-cycloplegic, cycloplegic, and subjective refraction. The history of trauma, hospitalization, and surgery due to trauma was collected from parents using a questionnaire.

Results

The data of the trauma history was recorded for 5267 out of 5620 students. The mean age of the students was 9.7 ± 1.7 years (range: 6–12 years), 53.7% of them were boys, and 79.3% were from urban areas. A positive history of ocular trauma was found in 285 participants, and the lifetime prevalence of ocular injury (95% CI) was 5.2% (4.6–5.9). Blunt trauma was the most common ocular injury with a prevalence of 66.2%. There was a significant positive assocation between ocular trauma and living in rural areas (OR: 1.49, p: 0.012), older age (OR: 1.17, p < 0.001), and male sex (OR: 1.62, p: 0.002). Furthermore, 9.3% and 4.7% of the traumas required hospitalization and surgical intervention, respectively.

Conclusion

This study found a marked prevalence of ocular trauma compared to previous studies. Male sex, older age, and living in rural areas were associated with ocular trauma, which could be due to differences in lifestyle preference, outdoor exposure, and dangerous situations. Educational programs and safety instructions should be encouraged.

The Demographic and Social Characteristics of Patients with Ocular Foreign Bodies in a Greek Tertiary Hospital

Purpose

Patients and Methods

Results

Conclusion

Open globe injuries: Epidemiology, visual and surgical predictive variables, prognostic models, and economic cost analysis

BACKGROUND

Open globe injuries (OGI) represent a visually and economically devastating cause of vision loss. We examined the epidemiology, predictive variables, prognostic models, and economic cost of surgically managed OGI.

METHODS

A retrospective tertiary centre study from 2008 to 2018 of 155 consecutive OGI in individuals aged 16 and older was performed. Medical records review, application of Ocular Trauma Score (OTS) and Classification and Regression Tree Analysis (CART) and cost analysis were undertaken. Key outcomes measured were visual acuity, number of operating theatre visits, prognostication using OTS and CART and estimated costs.

RESULTS

Younger males at work with inadequate protective eyewear (89.1%) and falls in the elderly were overrepresented. Inferior visual outcomes were associated with a more severe OTS score, a larger injury zone, increasing age, the presence of retinal detachment, extraocular muscle involvement, intraocular foreign body, and globe rupture (R²  = 0.723, p < 0.001). Multiple operating theatre visits were required in the presence of retinal detachment, lens or orbit involvement, work-related injury, globe rupture, and a history of previous intraocular surgery (R²  = 0.0423, p < 0.001). Both OTS and CART prognosticated outcomes (p < 0.001). The OTS predicted for no vision (no light perception/enucleation/evisceration) and profound visual loss (worse than 6/120; specificity: both 100%, sensitivity: 88.2% and 88%) whereas the CART predicted for visual survival (light perception or better) and minimal-to-severe visual loss (6/120 or better; specificity: 88.5% and 81.7% , sensitivity: 97.7% and 100%). Estimated annual OGI cost for Australia was AUD48.1-60.5 million (USD37.3-47.0 million).

CONCLUSIONS

The total cost of OGI is immense with young males and the elderly being disproportionately affected. Implementation of targeted government legislation and public health preventative measures may be cost-effective in ameliorating the significant burden.

Prognostic factors and long-term outcomes of eye-globe perforation: Eye injury vitrectomy study

PURPOSE

To delineate anatomic and visual outcomes of injured eye globes with perforating, and to develop the prognostic indicators for perforating eyes.

METHODS

The case series study, from a multicenter prospective cohort database. To the date of December 31st, 2018, of 63 perforating globes were selected. All cases underwent vitreoretinal surgeries or enucleations, and were followed up for at least 6 months. Demographic characteristics, basic examination for traumatized eyes, and intraocular tissue damages were recorded by surgery-in-chief. At the follow-up visit, best corrected VA, intraocular pressure, the intraocular tamponade material, retinal anatomic outcome of eye-globes, and phthisis or enucleation were evaluated.

RESULTS

Fifty injured eyes (79%) were caused by sharp objects and 13 eyes (21%) were injured by a missiles. Twenty-two injured eyes can be anatomically restored with final vision of more than 4/200 through vitreoretinal surgery. The PVR-C (OR = 5.67, P = 0.01), area of retinectomy more than 2 times of optic disk (OR = 5.16, P = 0.04), and macular damage (OR = 6.38, P = 0.01) were correlated with unfavorable outcomes.

CONCLUSION

The injured eyes with perforation can be saved through vitreoretinal surgery, the PVR-C, retinectomy more than 2 times of optic disk, and macular damage were independent risk factors for poor long-term prognosis.

Development of a Platelet Lysate-Based Printable, Transparent Biomaterial With Regenerative Potential for Epithelial Corneal Injuries

Purpose

To develop a human platelet lysate (hPL)–based bioink that is transparent and also encompasses the regenerative properties of hPL to facilitate wound healing.

Methods

The effect of different batches of hPLand fetal bovine serum (FBS) on corneal epithelial cell growth and scratch assay was first examined using Incucyte Zoom. Various combinations of human fibrinogen (concentration range from 0.2 to 5 mg/mL) and thrombin (concentration from 1 to 10 U/mL) were combined with hPL to generate nine types of potential bioink. Rheology, transparency, and cell compatibility of bioinks were assessed and compared. The final selected bioink was used in an ex vivo corneal model to examine its ability in re-epithelization.

Results

No significant difference was detected in cell proliferation and wound healing tests between different hPL batches at the same concentration. Scratch assay data showed that hPL had significantly higher effect on wound healing than FBS. Comparing across the nine bioinks, bioink 5 consisting of 10% hPL, 2 mg/mL fibrinogen, and 5 U/mL thrombin demonstrated all required mechanical and cellular properties and was able to regenerate the full-thickness epithelium ex vivo.

Conclusions

The results showed that a transparent and adhesive bioink can be generated by combining hPL, fibrinogen, and thrombin together. The bioink can be directly applied to a human cornea to promote corneal re-epithelization with huge potential applications in corneal injuries.

Translational Relevance

The developed transparent hPL-based ink with its adhesive and healing ability showed that it could be used as a new treatment option for corneal injuries.

Risk Factors and Prognosis of Pediatric Open Globe Injuries without Initial Light Perception

PURPOSE

The aim of this study was to investigate the possible risk factors and prognosis of initial no light perception (NLP) in pediatric open globe injuries (POGI).

PROCEDURES

This retrospective, comparative, interventional case-control study included 865 eyes of POGI patients presenting to a tertiary referral ophthalmic center from January 1, 2011 to December 31, 2015. Eyes were divided into 2 groups: the NLP group included eyes with initial NLP, and the light perception (LP) group included eyes with initial LP or vision better than LP.

RESULTS

The following risk factors were significantly related to initial NLP: severe intraocular hemorrhage (OR 3.287, p = 0.015), retinal detachment (RD; OR 2.527, p = 0.007), choroidal damage (OR 2.680, p = 0.016), and endophthalmitis (OR 4.221, p < 0.001). Choroidal damage is related to remaining NLP after vitreoretinal surgery (OR 12.384, p = 0.003). At the last visit, more eyes in the NLP group suffered from silicone oil-sustained status (OR 0.266, p = 0.020) or ocular atrophy (OR 0.640, p = 0.004), and fewer eyes benefitted from final LP (OR 41.061, p < 0.001) and anatomic success (OR 4.515, p < 0.001).

CONCLUSION

Severe intraocular hemorrhage, RD, choroidal damage, and endophthalmitis were possible predictors of initial NLP in POGI. Choroidal damage was the major factor related to an NLP prognosis. Traumatized eyes with initial NLP could be anatomically and functionally preserved by vitreoretinal surgery.

The Study of Incidence and Characteristics of Patients with Eye-Related Chief Complaints at the Emergency Department of Thammasat University Hospital

Background

Patients with eye-related chief complaints could be diagnosed not only with eye diseases but also with noneye diseases. This study determines rates and characteristics of patients with eye-related chief complaints at the Emergency Department of Thammasat University Hospital.

Methods

The study design is a descriptive retrospective observational study of patients with eye-related chief complaints at the Emergency Department of Thammasat University Hospital in 2017. Demographic data, diagnosis, management, consultation, and disposition were recorded by chart review. Categorical data were reported by percentage.

Results

Of the 52081 patients, 704 (1.3%) presented with eye problems. 60% of the patients were males. Patients were classified into three groups which are traumatic eye disease, nontraumatic eye disease, and noneye disease. 75.9% of the patients suffered traumatic injuries. The most common diagnoses of the traumatic eye injuries were foreign bodies at the cornea and conjunctiva and minor trauma to the conjunctiva. The most common mechanisms were foreign bodies in the eyes, cuts, or pierces. The most common causes of the injuries were from metals and housewares. The most common nontraumatic eye diagnoses were conjunctivitis and corneal ulcer. The most common noneye diagnoses were exposure of healthcare providers to secretions from patients, angioedema, and hypertensive crisis.

Conclusions

Most of the patients who came to the ER with chief complaints of the eyes could be treated by doctors in the emergency room without consulting ophthalmologists. Chief complaints of the eyes could be the leading symptoms of many organ systems. Emergency physicians should be differentially diagnosed to cover neurologic, cardiovascular, and immunologic problems.

Ocular trauma associated with falls in older people: A 10-year review from a state trauma service

BACKGROUND

Falls are the leading cause of injury-related emergency presentations, hospital admissions and deaths in Victorians over the age of 65. While there is extensive literature analysing traumatic injuries resulting from falls in older patients, there is little data on ocular injuries in this patient group.

METHODOLOGY

A retrospective audit of all patients over 65 years referred to the Ophthalmology Department of a tertiary hospital following fall from standing height between January 2009 and December 2018 to determine the demographics, injury setting, ophthalmic injuries, interventions and outcomes of ocular trauma secondary to falls.

RESULTS

Two hundred and seventy patients (F = 155, M = 115) were included, with a mean age of 81 years. 180 falls (66.7%) occurred in a residential environment. The most common reason for referral was orbital fracture (n = 155). Severe ocular injuries included globe rupture (n = 23), retro-bulbar haematoma (n = 22), retinal detachment (n = 6) and traumatic optic neuropathy (n = 6). Forty patients (14.8%) presented with a visual acuity (VA) below 6/60 while 34 patients (12.5%) had a non-assessable VA secondary to delirium or intubation. Of these 34, 9 had a significant ocular injury. A total of 28 patients (10.4%) were permanently blinded by their injuries. Twenty-three patients (8.5%) required admission to ICU and 16 patients (5.93%) died during their in-hospital stay. Thirty-six injuries were referred beyond the 24-hour mark, including a globe rupture and a case of traumatic optic neuropathy. With the exception of the missed globe rupture, all other injuries requiring emergency surgery were operated on within 24 h.

CONCLUSION

Falls in older people may be associated with sight-threatening ocular injuries which are common and easy to miss in this population demographic. The presence of ocular injuries in this patient group is associated with significant rates of in-hospital mortality and poor functional outcomes. It is therefore essential for trauma practitioners to perform a detailed and systematic assessment in order to identify sight-threatening ocular injuries and allow for expedient sight-saving intervention to be performed.

Global, national and regional prevalence, and associated factors of ocular trauma: A protocol for systematic review and meta-analysis

BACKGROUND

Ocular trauma is a common eye disease and one of the main causes of blindness. There is a dearth of data on a summary and meta-analysis on the global epidemiology of the disease. Therefore, this systematic review protocol aims to propose the first systematic review and meta-analysis to synthesize existing evidence on the global prevalence and associated factors of ocular trauma worldwide.

METHODS

A systematic search will be performed according to the following databases: PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Weipu, and Wanfang. Cross-sectional, case-control, and cohort studies reporting on the prevalence and risk factors of ocular trauma will be included. The primary outcome will be the prevalence in global, regional, and national ocular trauma. Study searching, data extraction, and quality evaluation will be performed by 2 reviewers, independently. Appropriate meta-analysis will then be used to pool studies. STATA software package v 12.0 (Stata Corporation, College Station, TX) and R (version 3.4.1; R Foundation for Statistical Computing, Vienna, Austria) software will be used for all statistical analyses.

RESULTS

This study will provide a high-quality synthesis to examine the prevalence and associated factors of ocular trauma worldwide. Furthermore, current study will project disease estimates in the next 50 years.

CONCLUSION

This systematic review and meta-analysis will provide first evidence to evaluate the burden of ocular trauma in the general population.

ETHICS AND DISSEMINATION

This systematic review and meta-analysis of randomized controlled trials does not require ethical recognition, and the results of this paper will be published in an open access, internationally influential academic journal.

TRIAL REGISTRATION NUMBER

CRD42020189166.

Epidemiology of outpatient and inpatient eye injury in Taiwan: 2000, 2005, 2010, and 2015

Purpose

To estimate the incidence rate of eye injuries (EI) requiring inpatient and outpatient treatment in Taiwan and compare the epidemiologic characteristics of EI (age, sex, treatment setting, seasonality, occupation, external cause, diagnosis, and surgery) in the years 2000, 2005, 2010, and 2015.

Methods

We analyzed four random samples of 1,000,000 beneficiaries each from 2000, 2005, 2010, and 2015 of the Taiwan National Health Insurance Program. The direct age-standardized rate, with 95% confidence interval (CI), was used to compare EI rates for the four calendar years. The chi-square test and chi-square test for trend were used to compare data for the four calendar years.

Results

Annual EI incidence rates were between 2.57% in 2000 and 3.28% in 2015. The age-standardized rates were 2.73% (95% CI, 2.70%–2.76%) in 2000, 3.37% (95% CI, 3.33%–3.41%) in 2005, 3.31% (95% CI, 3.28%–3.35%) in 2010, and 3.02% (95% CI, 2.99%–3.06%) in 2015. Manual workers had the highest EI incidence rate, followed by non-manual workers and civil servants. The proportion of EI requiring inpatient treatment declined from 1.34% in 2000 to 0.63% in 2015 (P <0.0001). Analysis of seasonality showed a consistent decrease in February in the four sampling years; however, this decrease in EI was only seen in outpatients, not in EI requiring hospitalization. The proportion of outpatients requiring surgery significantly decreased, from 2.53% in 2000 to 1.2% in 2015 (P<0.0001). However, the proportion of inpatients requiring surgery for EI as the principal diagnosis increased from 69.32% in 2000 to 83.02% in 2015 (P = 0.29), and the proportion of inpatients requiring surgery for EI as a secondary diagnosis increased from 54.86% in 2000 to 71.6% in 2015 (P = 0.0019). Among inpatients with EI, the most common cause of EI was a traffic accident (44.79%, especially motorcycles), followed by falls (9.75%) and homicide (6.05%).

Conclusion

In Taiwan, the annual EI incidence rate slightly increased from 2000 to 2005 and then decreased through 2015. The proportion of EI patients requiring hospitalization decreased from 1.34% in 2000 to 0.63% in 2015, but the percentage of inpatients requiring surgery increased. Traffic accidents (especially those involving motorcyclists) remained the predominant external cause of EI requiring hospitalization during the study period.

Epidemiology and visual outcomes of ocular injuries in a low resource country

BACKGROUND

Ocular injury is a major cause of ocular morbidity and unilateral visual impairment and represents a considerable public health concern especially in low resource societies.

OBJECTIVE

To evaluate the epidemiology and visual outcomes of ocular injuries in southern Ghana.

METHODS

A retrospective hospital-based case series was conducted. Information on new cases of ocular injuries were retrieved and parameters including time between injury occurrence and reporting to the clinic, presenting visual acuity (VA), and the best corrected final VA were investigated and visual outcomes were assessed Results: Most (50.2%) of the patients reported to the hospital after a day of sustaining an ocular injury; workplace injuries, older patients and farm-related injuries were most likely to report after a day of sustaining an injury. A significant proportion (40.4%) of patients reported with good presenting vision (6/6-6/18) which increased to 56.7% after treatment; 45.3% of patients reported with visual impairment (<6/18) and reduced to 42.4% after treatment. Farming (AOR = 4.5, p = 0.02), reporting after a day of sustaining injury (AOR = 78, p< 0.001), workplace injuries (AOR = 3.1, p = 0.007) and roadside injuries (AOR = 3.1, p = 0.02) were associated with poor visual outcomes. Initial VA 6/18 or better was the highest predictor of good visual outcome.

CONCLUSION

There is a shift in the pattern of ocular injury occurrence from work-related to home- related.

TRAFFIC ACCIDENT-RELATED OPEN GLOBE INJURIES

PURPOSE

To evaluate the clinical characteristics and visual outcomes of patients with traffic accident-related open globe injuries, and to examine preoperative factors influencing the visual prognosis after pars plana vitrectomy, as compared with common open globe injuries.

METHODS

Patients with open globe injuries, who underwent pars plana vitrectomy, were identified. Patients' demographic and clinical data were entered into a computerized database for review and analysis; data included age, sex, initial visual acuity, duration between onset of injury and surgery, information about the type and cause of injury, wound location and length, presence of ocular complications, and final visual acuity.

RESULTS

Of the 355 open globe injuries, 14 were sustained during a traffic-related accident; the average age was 50.4 years (range: 20-85) and most (78.6%) were men. Of these 14 patients, 9 (64.3%) presented with rupture and 5 (35.7%) with laceration. Injuries were caused while driving (6 eyes; 42.9%), riding a bicycle (5 eyes; 35.7%), involved in car accident while walking (2 eyes; 14.3%), and riding a motorbike (1 eye; 7.1%). Initial visual acuity was significantly related to final visual acuity (P = 0.003, R = 0.80). The final visual acuity in patients with traffic accident-related open globe injuries was significantly better than that of the total group (P = 0.01).

CONCLUSION

Traffic accident-related open globe injuries had better visual outcomes than common open globe injuries. Visual outcomes in patients with traffic accident-related open globe injuries were related to the initial visual acuity. No eyes developed endophthalmitis in patients with traffic accident-related open globe injuries.

Clinical Characteristics and Visual Outcomes of Patients Hospitalized for Ocular Trauma in Shandong Province, China

Purpose

To analyze the clinical characteristics and visual prognoses of patients with ocular trauma treated in Shandong Eye Hospital.

Methods

The inpatient data of patients with eye injuries hospitalized in our institution from January 2014 to December 2018 were retrospectively reviewed, including demographic information, types of trauma, causes of injury, treatment, and initial and final visual acuities.

Results

A total of 1,425 patients (1,622 eyes), aged 39.5 ± 18.5 years, were included. The ratio of male to female was 5.3 : 1. Of the mechanical eye injuries, there were 490 (34.4%) open-globe injuries and 454 (31.9%) closed-globe injuries. Nonmechanical eye injuries had 426 patients (29.9%), while 55 patients (3.9%) had adnexal injuries. Over a half of the traumas were work-related (51.1%, 728 patients). Most patients were treated with surgical intervention (1,404 eyes, 87.9%). There were significant differences in the final visual acuities between open-globe injuries and closed-globe injuries (P < 0.001), as well as between mechanical injuries and nonmechanical injuries (P < 0.001). The final visual acuity was closely correlated with the initial visual acuity (Spearman's correlation coefficient = 0.618, P < 0.001) and the OTS score (Spearman's correlation coefficient = 0.691, P < 0.001).

Conclusion

Ocular trauma usually occurs in young and middle-aged men and in the workplace in Shandong Province. The proportion of nonmechanical injuries is high, and the prognosis is poor. A comprehensive understanding of the characteristics of ocular trauma is useful for blindness prevention and treatment.

Ocular chemical burns in the workplace: Epidemiological characteristics

BACKGROUND

Epidemiological studies focusing on occupational pathologies can be an important medium through which to bring about change with respect to workplace accidents, both in terms of prevention planning and management as well as the appropriate care following an accident. Ocular chemical burns benefit from urgent attention as, if not treated early and appropriately, the tissue of the eye and its functionality can be seriously compromised. The objective of this study was to collate epidemiological data on workplace ocular chemical burns which could in turn serve to identify key action points in terms of occupational health.

METHODS

Cohort study with 604 cases of chemical burns to the eye occurring in the workplace between 2014 and 2015. Criteria inclusion were diagnosis of chemical burn, patient seen at the medical centre of the mutual society, workplace acquired ophthalmic pathology leading to the issuing of a sickness certificate. No exclusion criteria were defined.

RESULTS

Ocular chemical burns were the second most common workplace eye injury (12.68%) behind foreign bodies in the eye (43.42%). Men accounted for 68.54% of cases of ocular chemical burns. In around 75% of cases, sickness certification was for less than 7 days, although 6 patients suffered permanent disability. The occupational sector which was most affected particularly the industry service industry. The economic costs with these workplace injuries were extracted.

CONCLUSIONS

Appropriate early medical assistance is essential. The production and distribution of clinical guides for health care workers could optimise first line assistance and mitigate possible training deficiencies.

Epidemiology of eye injuries in a high-income developing country: An observational study

Vision loss following eye trauma is a serious health problem worldwide. The aim of the study was to report the epidemiology of eye injury that requires hospitalization and surgery at a secondary referral center in a high-income developing country so as to give recommendations regarding its prevention.All patients who had an eye injury that required surgical intervention between 2012 and 2017 at Al-Ain Hospital were retrospectively studied. Demography, cause of injury, and visual acuity before and after treatment were studied.Results revealed that 141 patients were operated, 96 eyes with open globe and 48 with other injuries. The median (IQR) age was 25 (11.5-37) years, 89% were males. Majority of injuries occurred at work (50.4%) followed by home (31.2%). Sharp objects (24.1%) and blunt trauma (16.3%) were the most common mechanism of injury. Eye injury was less during the weekends (Friday and Saturday) and during the summer vacation. Cornea injuries (48.2%) were the most frequent cause for visual acuity deterioration followed by lens/cataract (23.4%). Among injured eyes, 30 eyes (21.3%) retained intraocular foreign bodies. There was significant improvement of the visual acuity after surgery (P < .0001, Wilcoxon signed rank test).Our study has shown that eye injury is a major risk for visual loss of young people which is mainly work-related. Use of personal protective equipment for the eyes and adopting legislative eye safety regulations will reduce the impact of eye injuries in our community.

Epidemiology of ocular trauma in the Indigenous vs non-Indigenous population in the Top End

IMPORTANCE

Epidemiological data on visually significant ocular trauma in the Top End of the Northern Territory.

BACKGROUND

Our main objective is to determine whether Indigenous patients are disproportionately affected by visually significant ocular trauma as compared to non-Indigenous patients.

DESIGN

This was a retrospective audit at the Royal Darwin Hospital in the Top End of the Northern Territory during January 2013 to June 2015.

PARTICIPANTS

A total of 104 ocular trauma patients were included; 43 were Indigenous and 61 were non-Indigenous.

METHODS

Medical records of patients with ocular trauma between January 2013 and June 2015 (except simple, non-penetrating corneal foreign bodies and abrasions) were reviewed. Vision loss was defined by visual acuity: mild ≥6/18, moderate 6/18-6/60, severe ≤6/60 following World Health Organization standards.

MAIN OUTCOME MEASURES

The study included the incidence of ocular trauma patients by ethnicity (Indigenous vs non-Indigenous). Our secondary outcome included vision loss, mechanism of injury, open vs closed injury, age, remoteness and alcohol involvement.

RESULTS

A total of 104 patient charts were reviewed; 43 (41%) were Indigenous and 61 (59%) were non-Indigenous. Alleged assault was the greatest contributor to ocular trauma in both groups (74% in Indigenous vs 39% non-Indigenous). Severe vision loss was more prevalent in the Indigenous vs non-Indigenous patients (30% vs 16%).

CONCLUSIONS AND RELEVANCE

Indigenous patients were disproportionately affected by visually significant ocular trauma compared to non-Indigenous patients. This research provides important data on ocular trauma in the Northern Territory. Further prevention strategies are needed to reduce vision loss in this population.

Clinical characteristics and outcomes of open globe injuries in Japan

PURPOSE

To describe the epidemiology and clinical outcomes of open globe injuries (OGIs) in Japan over 10 years, and examine preoperative factors influencing the visual prognosis after surgery.

STUDY DESIGN

Retrospective, observational, multicenter case-series study.

METHODS

Patients' data were entered into a computerized database for review and statistical analyses. The following parameters were assessed; age, gender, initial and final visual acuity, duration between onset and surgery, presence of lens in the eye, characteristics of injury, presence of ocular complications, and number of surgeries.

RESULTS

The records of 374 eyes with OGI were enrolled. The average age of the patients was 56.8 ± 22.1 years, and the majority of patients were men (73.5%). Compared to the overall cohort, work-related OGI was the most common, associated with significantly better final visual acuity, whereas patients with fall-down OGI showed significantly worse final visual acuity (P < 0.05). Among the types of injury, both the initial and final visual acuity were significantly worse in the rupture group than in the laceration group. Multiple liner regression analyses revealed that the final visual acuity was significantly associated with initial visual acuity, type of injury (rupture), retinal detachment, and proliferative vitreoretinopathy.

CONCLUSION

To predict the visual outcome in patients with OGI, ophthalmologists need to pay attention not only to the initial visual acuity but also to initial ocular conditions, such as the presence of ocular complications.

The prevalence of vision loss due to ocular trauma in the Australian National Eye Health Survey

BACKGROUND

To determine the prevalence of vision loss due to ocular trauma in Australia.

METHODS

The National Eye Health Survey (NEHS) is a population-based cross-sectional study that examined 3098 non-Indigenous Australians (aged 50-98 years) and 1738 Indigenous Australians (aged 40-92 years) living in 30 randomly selected sites, stratified by remoteness. An eye was considered to have vision loss due to trauma if the best-corrected visual acuity was worse than 6/12 and the main cause was attributed to ocular trauma. This determination was made by two independent ophthalmologists and any disagreements were adjudicated by a third senior ophthalmologist.

RESULTS

The sampling weight adjusted prevalence of vision loss due to ocular trauma in non-Indigenous Australians aged 50 years and older and Indigenous Australians aged 40 years and over was 0.24% (95%CI: 0.10, 0.52) and 0.79% (95%CI: 0.56, 1.13), respectively. Trauma was attributed as an underlying cause of bilateral vision loss in one Indigenous participant, with all other cases being monocular. Males displayed a higher prevalence of vision loss from ocular trauma than females in both the non-Indigenous (0.47% vs. 1.25%, p=0.03) and Indigenous populations (0.12% vs. 0.38%, p=0.02). After multivariate adjustments, residing in Very Remote geographical areas was associated with higher odds of vision loss from ocular trauma.

CONCLUSIONS

We estimate that 2.4 per 1000 non-Indigenous and 7.9 per 1000 Indigenous Australian adults have monocular vision loss due to a previous severe ocular trauma. Our findings indicate that males, Indigenous Australians and those residing in Very Remote communities may benefit from targeted health promotion to improve awareness of trauma prevention strategies.

Epidemiology and clinical characteristics of patients hospitalized for ocular trauma in South-Central China

PURPOSE

Ocular trauma is a major cause of visual loss, but little is known about its epidemiology and clinical characteristics in China. The aim of this study was to determine the prevalence and clinical characteristics of ocular trauma and assess prognostic factors in Changsha, Hunan, located in South-Central China.

METHODS

A retrospective case series (ICD codes: S05) study of ocular trauma in patients was performed at the Second Xiangya Hospital, Central South University, from 1 January 2010 to 31 December 2014. Demographic information, injury causes, ocular trauma types and initial and final visual acuity (VA) were recorded and analysed. The ocular trauma score (OTS) was calculated to assess the extent of the eye injury, prognosis and factors associated with visual impairment. All patient data were collected from the medical records system.

RESULTS

Of the 2009 patients presenting during this 5-year period, 1695 (84.4%) were males and 314 (15.6%) were females. The average age of all patients was 37.0 ± 19.3 years (range from 1 to 87 years). The age distribution showed a peak in the ocular trauma population in the 41- to 50-year age group (24%, n = 482), followed by the 51- to 60-year age group (16.9%, n = 339). Overall, open-globe injuries had a higher frequency (70.7%, n = 1420) than closed-globe injuries (28.6%, n = 575) and thermal/chemical injuries (0.7%, n = 14). Of the open-globe injuries, corneal penetration was the most common injury (32.2%, n = 646) followed by rupture (21.5%, n = 432) and an intraocular foreign body (16.2%, n = 325). Overall, the most frequent ocular trauma setting was the workplace (39.6%, n = 795), followed by the home (28.4%, n = 570), and the most frequent activity was ironwork. Firecracker- and firework-associated ocular trauma was significantly higher during the months of January and February than during other months (50.0%, n = 112, p < 0.001). In patients under 18 years, the most frequently occurring injury was open globe (84.5%, n = 349) with corneal penetration (59.3%, n = 245). Overall, an operation was performed in 1865 (92.8%) cases, and 144 cases (7.2%) were treated conservatively with medication. The average OTS score was 47.1 ± 19.5. The visual prognosis was closely correlated with the initial VA (r = 0.570, p = 0.000) and the OTS score (r = 0.603, p = 0.000).

CONCLUSION

This study describes the epidemiology and clinical characteristics of patients hospitalized for ocular trauma in South-Central China. Notably, a high rate of firework-related ocular trauma occurred during the months adjacent to the Chinese New Year festival. Specific injury prevention strategies, such as the use of protective eyewear, need to target the workplace to reduce the incidence and severity of ocular trauma.

Prevalence, subtypes, severity and determinants of ocular trauma: The Singapore Chinese Eye Study

PURPOSE

To describe the prevalence, subtypes, severity and determinants of ocular trauma (OT) in a population-based study in Singapore.

METHODS

We included 3353 Chinese adults aged ≥40 years from the Singapore Chinese Eye Study, a population-based study, conducted between 2009 and 2011. OT was defined as self-reported history of any eye injury requiring medical attention with or without hospitalisation, and further classified as blunt object, sharp object or chemical burns related. Age and gender-standardised prevalence was estimated using the 2010 Singapore Chinese population census. Multivariable models were used to assess the independent associations of OT with age, gender, income, education, literacy, alcohol consumption, smoking and history of falls.

RESULTS

The mean (SD) age was 59.7 (9.9) years and 49.4% were male. There were 138 OT cases, giving a crude and age and gender-standardised prevalence of 4.1% (95% CI 3.5% to 4.8%) and 4.4% (95% CI 3.7% to 5.2%), respectively. Of these, 45 (32.6%), 56 (40.6%) and 10 (7.3%) were blunt object, sharp object and chemical burns-related trauma, respectively. Twenty eight (20.3%) required hospitalisation, with no difference between subtypes. In multivariable models, men (OR (95% CI): 2.80 (1.79-4.39)), younger persons (per year decrease in age (1.03 (1.00-1.05)) and lower education levels (1.8 (1.25-2.60); comparing ≤6 years vs >6 years of education) were independent determinants of OT.

CONCLUSIONS

OT affected one in 25 adults, with 20% of these requiring hospitalisation. Because OT is preventable, raising awareness and education strategies in the population would allow prevention of vision loss particularly in men, and younger and lesser-educated individuals.

Ocular traumas in working age adults in Finland - Helsinki Ocular Trauma Study

PURPOSE

To describe epidemiology, causes, treatments and outcomes of ocular injuries in adults aged 17 to 60 in southern Finland.

METHODS

All new ocular trauma patients admitted to the Helsinki University Eye Hospital (HUEH), during 1 year in 2011-2012. The data were from hospital records and prospectively from patient questionnaires. The follow-up time was 3 months.

RESULTS

The incidence for ocular injury was 88/100 000/year. From 831 trauma patients, 80% were men, 34% were work-related injuries, and 11% were assaults. Most of the injuries were minor traumas (54%). Contusions (22.5%) and chemical injuries and burns (13%) were common. Fractures (5%), lid wounds (3%), open globe injuries (OGI, 2%) and optic nerve injuries (0.5%) were rare. The main causes of ocular injury were superficial foreign bodies (33%), chemicals (13%), body parts (13%) and sports equipment (10%). The most dangerous objects were needles, stones, pellet guns, tools and guns. No patient with OGI used protective eyewear. All OGI and most of contusions needed a lifelong follow-up. Permanent impairment (73 patients, 9%) was caused most often by body parts, sports equipment and work tools.

CONCLUSION

A typical ocular trauma patient was a man aged 31-45 with a minor trauma caused by a foreign body at work and a final visual acuity of 20/20. Most common serious injuries were contusion, OGI or fracture at home or at work and were caused by a body part, sport equipment or work tool. Factors causing common and serious eye injuries provide the targets for protective measures.

A Retrospective Study on Clinical Features and Visual Outcome of Patients Hospitalized for Ocular Trauma in Cangzhou, China

Purpose. To describe clinical features and to analyze visual outcome of ocular trauma in Cangzhou in 2012–2015, China. Methods. A retrospective study of ocular trauma cases admitted to Cangzhou Central Hospital from January 2012 till December 2015 was performed. Results. This study included a total of 507 eyes from 478 patients. Four hundred (83.7%) patients were male, with a male-to-female ratio of 5.1 : 1. Mean age was 43.6 ± 18.3 years (5–95 years). The largest age group was 45–59 years old, followed by 30–44 years old, presenting two peaks of the age distribution and accounting for 28.5% and 27.2%, respectively. The most frequent type of injuries was work-related (194, 40.6%) followed by home-related (123, 25.7%). Initial visual acuity (VA) correlated with final VA (Spearman's test, r = 0.703, p = 0.001). The Ocular Trauma Score also correlated with the final VA significantly (Spearman's test, r = 0.802, p = 0.001). Conclusions. Susceptible population of eye injuries were middle- and young-aged working groups, and the proportion of males was higher. The leading two types of ocular trauma were work-related and home-related. Initial VA was a significant predictor of the final VA and the OTS possibly had predictive value in the final VA.

Epidemiological Features of Pediatric Ocular Trauma in Egypt

Purpose. To review the epidemiology of serious pediatric ocular trauma presenting to Kasr El Aini Hospital, Cairo University. Methods. Children with serious ocular trauma during a six-month period were examined and their data was analyzed. Results. Eighty eyes of 75 patients were included in this study, with 64% males (P < 0.001) and average age of 5 years (5 months–15 years). There were 67 (83.75%) open globe injuries, 11 (13.75%) closed globe injuries, and 2 (2.5%) chemical injuries. Of the open globe injuries, 24 (30%) were ruptured globes and 43 (53.75%) were lacerations (31 penetrating injuries (38.75%), 6 IOFBs (7.5%), and 6 perforating injuries (7.5%)). Of the closed globe injuries, 3 had hyphema (3.75%), 5 had traumatic cataracts (6.25%), and 3 had vitreous hemorrhage with retinal detachment (3.75%). Forty-two patients (56%) presented within 24 hours, 28 patients (37.33%) presented between 24 hours and 1 week, and 5 patients (6.6%) presented after one week from the time of trauma. Seven eyes developed posttraumatic endophthalmitis (10% of open globe injuries). On leaving the hospital, 55 (68.75%) eyes had poor vision, 13 (16.25%) had moderate vision, and 12 (15%) had good vision. Conclusion. Children at a higher risk of trauma are males, >5 years, unsupervised, and involved in street activities. Immediate comprehensive primary management and secondary rehabilitation are mandatory in these cases.

Determinant Factors of Poor Visual Outcome After Ocular Trauma: A Retrospective Study in Central Sarawak, Malaysia

PURPOSE

To study the demographic characteristics of ocular trauma in Central Sarawak and identify the determinant factors of poor visual outcome.

DESIGN

A retrospective study of ocular trauma cases presenting at the referral hospital in 2013.

METHODS

Patients were identified and recruited from hospital records. Those presenting for follow-up review were excluded. Case records were retrieved and reviewed after recruitment.

RESULTS

We studied 168 patients with 179 ocular injuries, of which 44% were work related. Compared with non-work-related cases, work-related cases were more likely to be male [odds ratio (OR), 19.7; 95% confidence interval (CI), 2.6-150.9] and foreign (OR, 18.0; 95% CI, 2.3-142.0). Open globe injuries constituted a higher percentage of impaired visual acuity (VA) during the first visit: 84.6% compared with 18.1% for closed globe injuries (OR, 25.0; 95% CI, 5.3-118.4; P < 0.001). Of the open globe injuries, 61.5% worsened or showed no improvement in VA after 3 months compared with closed globe injuries (28.9%) (OR, 3.9; 95% CI, 1.2-12.7; P = 0.015). Of cases presenting 7 or more days after trauma, 76.9% worsened or showed no improvement in VA after 3 months compared with those presenting in less than 7 days (27.7%) (OR, 8.7; 95% CI, 2.3-33.0; P < 0.001). Among those with work-related injuries, 23.1% had used eye protective devices (EPDs).

CONCLUSIONS

Ocular injuries in Central Sarawak were predominantly work related, occurring at industrial premises, and involving males and foreigners. Both open globe injuries and a delay in seeking treatment resulted in significantly poorer visual outcomes.

Past History of Ocular Trauma in an Iranian Population-Based Study: Prevalence and its Associated Factors

Purpose:

The purpose of this study was to determine the prevalence of a history of ocular trauma and its association to age, sex, and biometric components.

Materials and Methods:

Residents of Shahroud, Iran aged 40–64 years, were sampled through a cross-sectional study using multistage cluster sampling. Three hundred clusters were randomly selected, and 20 individuals were systematically selected from each cluster. The subjects underwent optometric and ophthalmic examinations, and ocular imaging. A history of ocular trauma was determined through personal interviews.

Results:

The prevalence of a history of trauma and blunt trauma, sharp trauma, and chemical burns were 8.57%, 3.91%, 3.82%, and 1.93%, respectively. After adjusting for age, the rate of all types of trauma was significantly higher for males. Only the prevalence of chemical burns significantly decreased with aging. A history of hospitalization was stated by 1.64% of the subjects. The axial length was significantly longer in cases with a history of trauma. The corneal curvature was significantly larger in cases with a history of sharp trauma and chemical burns. The prevalence of corneal opacities was significantly higher among cases with a history of the blunt trauma odds ratio (OR = 2.33) and sharp trauma (OR = 4.46). Based on corrected visual acuity, the odds of blindness was 3.32 times higher in those with a history of ocular trauma (P < 0.001).

Conclusion:

A considerable proportion of the 40–64-year-old population reported a history of ocular trauma. This observation has important health implications. Blindness, corneal opacities, and posterior subcapsular cataract were observed more frequently among these cases, and they demonstrated differences in some ocular biometric components.

[Epidemiology of open globe injuries in the Tunisian region of Cap Bon: Retrospective study of 100 cases]

PURPOSE

The goal of our study was to assess the epidemiological characteristics of ocular injuries in the Cap Bon region.

PATIENTS AND METHODS

We retrospectively reviewed the records of 100 patients, hospitalized and treated in the department of ophthalmology at the Mohamed Taher Maamouri university medical center in Nabeul, Tunisia for an open globe injury between January 2006 and November 2013. The mean duration of follow-up was 15.9 months.

RESULTS

The average age of the patients was 31.9 years. Domestic accidents accounted for 30% of cases of trauma, followed by violence (29%). The trauma was sharp in most cases (54%). The injury was penetrating in most cases (65.7%). The initial visual acuity was ≤ 1/10 in 69.8% of cases. The wound was isolated to the cornea in 59.7% of cases and scleral in 25% of cases. The most common associated ocular lesions were traumatic cataract (35%), followed by hyphema (32%). An intraocular foreign body was present in 4% of cases. At the final examination, 41.8% had a final visual acuity ≤ 1/10.

CONCLUSION

Open globe injuries represent a real public health problem given their psychological and functional repercussions. The best treatment is preventative, involving better awareness in the family, school and work environment.

Outcome of vitrectomy and chorioretinectomy in perforating eye injuries

PURPOSE

To evaluate the anatomical and functional results of patients who underwent pars plana vitrectomy for perforating eye injuries as well as to analyze the benefit of the chorioretinectomy procedure.

METHODS

Retrospective and descriptive study of 24 eyes of 22 patients with perforating eye injuries operated on at the Centro Hospitalar do Porto between January 2006 and December 2012.

RESULTS

An early vitrectomy was accomplished in 67% of the eyes and a delayed vitrectomy in 33% of the eyes. A concomitant chorioretinectomy was carried out in 78%. Final proliferative vitreoretinopathy (PVR) was found in 11%. The anatomical success was 83%. At the final follow-up, 78% had best-corrected visual acuity equal to or superior to 5/200. Of the eyes that underwent early vitrectomy, 58% regained a visual acuity of 40/200 or better, versus 17% of the cases that underwent delayed vitrectomy.

CONCLUSION

Early vitrectomy with prophylactic chorioretinectomy seems to be an effective approach to prevent PVR and improve the visual outcome and globe survival in perforating injuries.

Open-globe injuries with motor vehicle accidents: a 12-year review

PURPOSE

To evaluate demographics, characteristics, and outcomes of open-globe injuries (OGIs) in motor vehicle accidents (MVAs).

METHODS

Retrospective chart review of patients with OGIs related to MVAs that presented to University Hospital, Newark, from 2000 to 2012.

RESULTS

Twenty-five patients were identified; the average age of the patients was 33.3 years old (range, 5-75). The majority of patients (64 %) were males. The 25 vehicles comprised 24 automobiles and one motorcycle. Ten patients (40 %) wore seatbelts, and five (20 %) did not wear seatbelts. The seatbelt status was not documented in the remaining cases. Ethanol was documented as a contributing factor in five of the accidents. In terms of open-globe classification, 15 OGIs (60 %) were ruptures, and five (20 %) were penetrating injuries; three (12 %) had intraocular foreign bodies. Ten eyes (40 %) had a final VA of 20/400 or worse. Fourteen eyes (56 %) achieved a final VA of 20/200 or better; seven eyes (28 %) achieved a final VA of 20/40 or better.

CONCLUSION

Fifty-six percent of eyes with an open-globe injury related to MVAs achieved a final VA of 20/200 or better in this series. No eyes developed endophthalmitis.

Ocular trauma: 2 years retrospective study in sari, iran

Introduction:

Ocular trauma is one of the very important causes of blindness and disability in developing countries; despite the fact that it is preventable in the majority of cases. Considering the importance of the topic and the fact that most of such injuries are preventable, a better understanding of the etiology and epidemiology of the injuries has a vital importance in planning for reduction of their prevalence. The current study has aimed to identify the prevalence and epidemiology of the ocular trauma at the University Hospital Boo-Ali-Sina in the city of Sari (Northern Iran) between 2009-2010.

Method:

This is a retrospective study of 178 patients’ case notes who were admitted through the ophthalmology service to the above center. A proforma was designed and For the purpose of classification, the International Classification of Diseases (ICD-10) was used.

Results:

During the study period, 178 patients with eye trauma were admitted to the hospital of these, 135 (75.8%) male and 43 (24.2%) were female. 35 (19.7%) aged 25-34 and 98 (55.1%) cases lived in villages. The injuries were most common during winter (55/30.9% of cases). The most common diagnosis was open wound of eyelid (ICD-10 code: S01.1) (40/ 22.5% of cases) and in the majority of cases it was unilateral (left eye) (96/53.9%). The mode of the trauma was contact with blunt object in 22 (12.4%) cases (ICD-10 code: Y29).

Conclusions:

Considering the prevalence of ocular trauma, appropriate education and the use of safety equipment are important measures to prevent the injuries. Our data shows that the prevalence of the injuries amongst the young workers is high and this necessitates the age group to be the target for such education. The education should include the vulnerable population at both extremes of age.

Clinical characteristics and surgical problems of ruptured globe injury

BACKGROUND

Ocular trauma is a major cause of vision loss, especially in the young patients, and is the leading cause of unilateral blind in China.

OBJECTIVE

The aims of this report are to analyze ciliary and choroidal lesion characteristics and outcomes of a group of patients with ruptured globe injuries and discuss finding a more effective treatment protocol. Here we report our experience treating ruptured globe injuries.

METHODS

Seventy-five patients (75 eyes) with a diagnosis of ruptured globe injuries were selected from 264 patients with open globe injuries at the Shierming Eye Hospital of Shandong Province between January 2009 and December 2011. General information and clinical characteristics such as ciliary and choroidal lesion features were reviewed.

RESULTS

Of the 75 patients, 85.3% were men, and the average age of the patients was 37.2 years (range, 6-63 years). The right eye was injured in 52.0%; enucleation was performed in 9 patients. There was no light perception, in the final corrected visual acuity in another 3 patients. The ratio of better visual acuity (better than 0.1) increased from 0 preoperatively to 16.0% postoperatively. Among the 75 patients with ruptured globe injuries, 13 had ciliary injury and 47 (62.7%) had choroidal injuries. Both ciliary and choroidal injuries were detected in 15 patients. Retinal tissue incarceration during sclera suturing was usually the vital point leading to unfavorable results.

CONCLUSIONS

Ruptured globe injury usually results in severe visual acuity damage. Active treatment could help to restore visual acuity in patients to some degree. Some effective treatment protocols for ruptured globe injuries could be followed. Some unsuitable procedures in primary treatment should be avoided to achieve a better prognosis.

Forensic analysis of ocular injuries during the 2011 revolution in Egypt

INTRODUCTION

During the year 2011 the Egyptian revolution arose with a change in the trend of eye trauma in Egypt.

AIM OF WORK

This study aims at reviewing the epidemiology of ocular trauma presenting to Ain Shams University teaching hospital during the year 2011 and comparing it with epidemiology during the previous 5 years.

PATIENTS AND METHODS

This is a retrospective epidemiological and clinical study of patients admitted to Ain Shams University Hospital with ocular trauma from 2006 till 2011. Cases were analyzed with respect to age, sex, occupation, admission interval, type, mode, time and place of injury, causative instrument, diagnosis and examination findings, investigations, management and visual outcomes.

RESULTS

Total numbers of cases presenting during the year 2011 was 237 cases. The mean age was 22.5 years. Students (47.2%) and jobless people (21.9%) constituted the majority of the sample. During the year 2011 there was a significant increase in the percentage of injuries occurring in the street. There was also a significant rise in the percentage of homicidal ocular injuries specially those caused from non-rifled weapons. Fourteen cases of endophthalmitis were associated with non-rifled fire arm missiles while 7 were associated with glass intra-ocular foreign body. This indicated that the probability of occurrence of endophthalmitis with metal intraocular foreign bodies was 2:3 i.e. 66.6% where as in glass intra ocular foreign body was 7:9 i.e. 77.7%.

CONCLUSION

The majority of ocular trauma in our population during the year 2011 was due to homicidal street injuries occurring mainly in males of young age group, which is consistent with the events occurring in Egypt in this year. The findings indicate that ocular trauma is a significant cause of visual loss in this population.

Aetiology and outcome of open and closed globe eye injuries in children

BACKGROUND

This paper reports on the aetiology and outcome of childhood open and closed globe eye injuries presenting to the Children's Hospital at Westmead, Sydney, Australia from January 2000 to December 2008.

DESIGN

Hospital-based retrospective study.

PARTICIPANTS

Two hundred three cases of childhood eye injuries identified in a nine-year period, comprising 81 open globe and 122 closed globe injuries.

METHODS

Hospital records were examined for demographic data and injuries were classified into open globe and closed globe, based on the Ocular Trauma Classification.

MAIN OUTCOME MEASURES

Parameters affecting the final visual outcome such as type of injury, zone of injury, initial visual acuity, wound length (only in open globe injuries) and lens injury were assessed.

RESULTS

Most of the eye injuries resulted from the child poking itself or being poked accidentally (26%), with the home being the most common place of injury. A favourable visual outcome was noted with closed globe injuries as compared with open globe injuries (P < 0.01). Parameters that indicated a poor visual outcome included globe ruptures, zone 3 injuries, poor initial visual acuity, wound length >10 mm and lens trauma. Final visual acuity of 6/12 or better was observed in 68% of injured eyes.

CONCLUSIONS

This study demonstrated improved visual outcomes when compared with previous studies. However, many unsalvageable childhood eye injuries with little useful vision were evident, and most disconcerting is that the majority of childhood eye injuries in this study were preventable.

Spectrum of intra-ocular foreign bodies and the outcome of their management in Brunei Darussalam

To review the etiologies, prognostic factors and treatment outcomes of intraocular foreign bodies (IOFBs) occurring in the population of Brunei Darussalam, and provide guidelines to prevent and manage such injuries. A retrospective review was performed for all cases of traumatic IOFBs managed in our centre during a 3-year period between May 2008 and April 2011. The mechanism of injury, management, complications and visual outcomes were analyzed. Majority of the patients were males (93 %) and the mean age was 36 years. The main causes of trauma were metal hammering and grass cutting (43 % each). Other causes include road traffic accidents and firecracker explosion (7 % each). The visual outcome was ≥6/18 in 50 % and 'No perception of light' in 29 %. Causes of poor visual outcome were retinal detachment with proliferative vitreoretinopathy (21 %), endophthalmitis (21 %) and globe maceration (7 %). Prognostic factors associated with significantly worse final visual outcome included posterior location of the IOFB (p = 0.05) and larger IOFB size (p < 0.001). The time from injury to surgery did not correlate with a worse visual prognosis. In Brunei Darussalam, the commonest causes of IOFBs are hammering metal and cutting grass using power tools. The visual outcome varies between 6/6 and NPL. Poor visual outcome is related to the severity of the initial ocular injury, posterior segment IOFB and endophthalmitis.

Epidemiology of patients hospitalized for ocular trauma in the Chaoshan region of China, 2001-2010

BACKGROUND

The burden and pattern of ocular trauma in China are poorly known and not well studied. We aimed at studying the epidemiological characteristics of patients hospitalized for ocular trauma at major ophthalmology departments in the largest industrial base of plastic toys in China.

METHODS

A retrospective study of ocular trauma cases admitted to 3 tertiary hospitals in China from 1st January 2001 to 31st December 2010 was performed.

RESULTS

The study included a total of 3,644 injured eyes from 3,559 patients over the 10-year period: 2,008 (55.1%) open-globe injuries, 1,580 (43.4%) closed-globe injuries, 41 (1.1%) chemical injuries, 15 (0.4%) thermal injuries and 678 (18.6%) ocular adnexal injuries. The mean age of the patients was 29.0±16.8 years with a male-to-female ratio of 5.2∶1 (P = 0.007). The most frequent types of injury were work-related injuries (1,656, 46.5%) and home-related injuries (715, 20.1%). The majority of injuries in males (56.2%) and females (36.0%) occurred in the 15-44 age group and 0-14 age group, respectively. The final visual acuity correlated with the initial visual acuity (Spearman's correlation coefficient = 0.659; P<0.001). The Ocular Trauma Score also correlated with the final visual acuity (Spearman's correlation coefficient = 0.655; P<0.001).

CONCLUSIONS

This analysis provides an epidemiological study of patients who were hospitalized for ocular trauma. Preventive efforts are important for both work-related and home-related eye injuries.