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Ono T, Iwasaki T, Mori Y, Nejima R, Miyai T, Aihara M, Miyata K. Pattern of Ocular Injuries Following Road Traffic Accidents Seen at a Tertiary Eye Hospital. Cureus 2024; 16:e59126. [PMID: 38803748 PMCID: PMC11129535 DOI: 10.7759/cureus.59126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION Traffic trauma can lead to ocular damage. Open globe injuries usually have a poor prognosis, which can be ameliorated by prompt diagnosis and appropriate treatment. Nonetheless, few studies have focused on the visual outcomes of patients following traffic accidents. In this study, we aimed to examine the characteristics and prognosis of ocular complications in patients following traffic accidents at a specialized tertiary eye hospital. METHODS We classified 44 patients from traffic accidents (88 eyes) into groups with equal or better (better group) and worse (worse group) corrected-distance visual acuity than a logarithm of the minimum angle of resolution 0 at the initial presentation. Final corrected-distance visual acuity, intraocular pressure, corneal injury, presence of traumatic cataracts, and treatment were compared between the groups. In addition, a multivariate linear regression analysis was performed to identify factors associated with the final visual acuity. RESULTS Globe contusion, orbital blowout fracture, traumatic iritis, and trochlear nerve palsy were observed in 14.8%, 3.4%, 2.3%, and 2.3% of the patients, respectively. Topical instillation and ophthalmological treatment/surgery were performed in 17.0% and 9.1% of the patients, respectively. The better group (68 eyes) had significantly better final visual acuity than the worse group (20 eyes) (P < 0.001). However, there was no between-group difference in demographic characteristics. Multivariate analysis demonstrated that there was a significant correlation between the initial and final visual acuities (P < 0.001). CONCLUSIONS Assessing visual acuity at the initial presentation is crucial for predicting the final visual acuity. Our findings will help to inform ophthalmologists aiming to improve the prognosis and treatment of ocular trauma in patients following traffic accidents.
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Affiliation(s)
- Takashi Ono
- Ophthalmology, University of Tokyo, Tokyo, JPN
| | | | - Yosai Mori
- Ophthalmology, Miyata Eye Hospital, Miyakonojo, JPN
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Kyriakaki EDO, Detorakis ET, Bertsias AK, Tsakalis NG, Karageorgiou I, Chlouverakis G, Symvoulakis EK. Clinical and Social Features of Patients with Eye Injuries Admitted to a Tertiary Hospital: A Five-Year Retrospective Study from Crete, Greece. Healthcare (Basel) 2023; 11:healthcare11060885. [PMID: 36981542 PMCID: PMC10048775 DOI: 10.3390/healthcare11060885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/06/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Eye injuries are a major cause of visual disability worldwide and may present a burden to both quality of life of the sufferers and healthcare services. The aim of this study was to extract and triangulate information on the demographic, clinical, and social features of eye-injured adult patients admitted to a tertiary hospital in Greece. The design was a five-year retrospective study of eye-injured adult patients, admitted to the General University Hospital of Heraklion, Crete (GUHH), the single tertiary referral hospital on the island. Drawing the profile of eye-injured patients may add to future health planning. Data collected from 1 January 2015 to 31 December 2019, such as sociodemographic features and clinical information, were extracted. One hundred twenty-eight patients were included. Of those, there was no available information on activity during injury for 6 patients, 78 (60.9%) had work-related ocular injuries, and 44 (34.4%) had non-work-related ocular injuries. Patients with no current formal employment, those who were retired, and formally unemployed and manual force workers had the higher rates of work-related injuries. The most common work-related injuries were closed globe injuries, specifically contusions, while ruptures and penetrating wounds were the most frequent of the open globe injuries. Within the univariate analyses, work-related eye injuries were significantly associated with male gender, middle age, and the place related to daily work activity. Determinants of poor final visual acuity (VA) were the initial VA, the type of injury (p < 0.0001), the distance of the place of residence from the hospital, and the time to hospital admission (p < 0.013). In a multivariate analysis, referred patients and those with open globe injuries arrived at hospital after a two-hour interval compared with those who were not referred and those with closed globe injuries (p ≤ 0.05). A reduction in the time to hospital admission deserves further attention. The interconnection of community and health system services through a capacity increase and networking needs further research in order to obtain targeted and viable access for eye-injured patients.
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Affiliation(s)
- Elli D O Kyriakaki
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Efstathios T Detorakis
- Department of Ophthalmology, University Hospital of Heraklion, Crete, 71500 Heraklion, Greece
| | - Antonios K Bertsias
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Nikolaos G Tsakalis
- Department of Ophthalmology, General Hospital of Ierapetra, 72200 Ierapetra, Greece
| | | | - Gregory Chlouverakis
- Department of Social Medicine, Biostatistics Lab, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Emmanouil K Symvoulakis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece
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Kyriakaki ED, Detorakis ET, Bertsias AK, Markakis G, Tsakalis NG, Volkos P, Spandidos DA, Symvoulakis EK. Ocular trauma, visual acuity related to time of referral and psychosocial determinants, during COVID‑19 pandemic: A prospective study. Exp Ther Med 2023; 25:130. [PMID: 36845962 PMCID: PMC9947913 DOI: 10.3892/etm.2023.11829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023] Open
Abstract
The aim of the present study was to explore the associations between visual outcomes of ocular injury patients in a tertiary hospital unit with clinical and demographic variables and to evaluate the psychosocial impact of the injury on the patients. An 18-month prospective study of 30 eye-injured adult patients was conducted in the General University Hospital of Heraklion, Crete, a tertiary referral hospital. All severe eye injury case information was prospectively collected between February 1, 2020 and August 31, 2021. Best corrected visual acuity (BCVA) was labelled not poor (>0.5/10 or >20/400 on the Snellen scale, <1.3 in LogMAR scale) and poor (≤0.5/10 or ≤20/400 on the Snellen scale, ≥1.3 on the LogMAR equivalent). Data regarding participants' perceived stress levels, by using Perceived Stress Scale 14 (PSS-14), were collected prospectively, one year after study end. Out of 30 ocular injury patients selected, 76.7% were men and most of them were self-employed and private or public sector workers (36.7%). Not poor final BCVA was related to not poor initial BCVA [odds ratio (OR) 1.714; P=0.006]. No statistical associations were found between visual outcome and demographic or clinical factors, but not poor final BCVA was associated with improved self-reported psychological condition of the sufferers, as examined by a questionnaire sheet developed to collect information for study purpose (8.36/10 vs. 6.40/10; P=0.011). No patient reported job loss or changed work status following the injury. Not poor initial BCVA was a significant predictor for not poor final visual outcomes (OR 1.714; P=0.006). Patients with not poor final BCVA expressed higher levels of positive psychology (8.36/10 vs. 6.40/10; P=0.011) and less fear of eye injury repetition (64.0 vs. 100.0%; P=0.286). Not poor final BCVA was associated with low PSS-14 scores one year after study end (77.3 vs. 0.0%, P=0.003). Collaboration between ophthalmologists, mental health professionals and primary care team may be important in order to help patients to cope with the psychosocial burden sequel to eye trauma.
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Affiliation(s)
- Elli D.O. Kyriakaki
- Department of Ophthalmology, University Hospital of Heraklion, 71500 Heraklion, Greece
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece
| | | | - Antonios K. Bertsias
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Georgios Markakis
- Department of Social Work, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Nikolaos G. Tsakalis
- Department of Ophthalmology, University Hospital of Heraklion, 71500 Heraklion, Greece
- Department of Ophthalmology, General Hospital of Ierapetra, 72200 Ierapetra, Greece
| | - Panagiotis Volkos
- 4th Local Health Team, Academic Unit of Heraklion, 71303 Heraklion, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Emmanouil K. Symvoulakis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece
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Kim EJ, Ganga A, Kang C, Elnemer W, Lee JY, Ronquillo YC, Hoopes PC, Moshirfar M. Motorcycle-Associated Ocular Injuries: A Narrative Review. Clin Ophthalmol 2022; 16:3457-3479. [PMID: 36267681 PMCID: PMC9576601 DOI: 10.2147/opth.s387034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose Motorcycle-related injuries involving the eye and orbit are not well characterized, with a paucity of prospective studies focusing specifically on motorcycle-associated eye injuries nor literature reviews having been conducted on the subject. To better understand the injury types and descriptive characteristics of patients experiencing motorcycle-associated eye injuries, we sought to conduct a narrative review. Methods The research team utilized the following databases: PubMed, EMBASE, and Web of Science to query for English articles from peer-reviewed journals that provided some patient data regarding eye injury due to motorcycle or moped accidents or usage. Results A total of 65 studies were included in our qualitative synthesis. Of these studies, 40 (61.5%) were case reports, 20 retrospective case series (30.8%), and five (7.69%) were observational prospective studies. Among the 25 retrospective and prospective studies, 12 (48.0%) of these studies primarily focused on motorcycle-associated injuries. These 65 studies described a wide variety of motorcycle-associated eye injuries, including but not limited to orbital fractures and associated sequelae, foreign bodies, vitreoretinal trauma, neuro-ophthalmic trauma, corneal injuries, open globe injuries, lacerations, and globe avulsions. Conclusion The current state of the literature indicates that knowledge regarding the ocular manifestations of motorcycle accidents is limited to mostly case reports and few retrospective cohort studies focused specifically on motorcycle-associated eye injuries. However, it is evident that the types of motorcycle-associated eye injuries are legion and predominantly seen in adult males, potentially leading to severe injuries and loss of vision and blindness.
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Affiliation(s)
- Eric J Kim
- Division of Ophthalmology, Warren Alpert Medical School at Brown University, Providence, RI, USA,Correspondence: Eric J Kim, Division of Ophthalmology, Warren Alpert Medical School at Brown University, Providence, RI, USA, Tel +1 978-289-0659, Email
| | - Arjun Ganga
- Division of Ophthalmology, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Chaerim Kang
- Program in Liberal Medical Education, Brown University, Providence, RI, USA
| | | | | | | | | | - Majid Moshirfar
- Hoopes Vision Research Center, Draper, UT, USA,John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA,Utah Lions Eye Bank, Murray, UT, USA
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