Factors affecting ocular trauma in Iran: A systematic review study

Background and Aims

Ocular trauma (OT) is a a major cause of ocular morbidity and blindness. This study was systematically conducted to determine the factors contributing to OT in Iran.

Methods

In this study, a systematic review of all published articles in Persian and English languages from 2000 to 2023 was conducted to investigate the factors affecting OT in Iran. The included studies encompassed cross-sectional, cohort, and case-control designs. Articles were selected from internationally recognized databases, including PubMed, Web of Science, Scopus, and Google Scholar, as well as Persian databases such as SID and Magiran. The search strategy involved using keywords aligned with the (MeSH) terms, such as "oculars," "trauma," and "Iran." Initially, 403 articles were identified, and ultimately, 14 articles met the inclusion criteria. To ensure the prevention of bias and assess the quality of the selected articles, the Newcastle-Ottawa Scale was utilized.

Result

In the present study, the majority of individuals in the reviewed articles were categorized as having mild eye injuries (13.8%). A higher percentage of injuries was observed in males compared to females, and a higher prevalence of injuries was also observed in the age group of over 30 years compared to other age groups. Among the mechanical causes, sharp trauma had the highest prevalence rate (72.5%), while falls had the lowest prevalence rate (14%), followed by sport-related injuries (29%). Non-mechanical injuries were mentioned in only one article and had a prevalence rate of 1.5.

Conclusion

The results of the current research have shown that among the mechanical injuries, accidents involving motorcycles and sharp objects are the leading causes of OT in Iranians. Therefore, the use of protective equipment such as goggles and adherence to traffic laws play a particularly important role, especially in men higher the age of 30. These findings highlight the necessity for targeted educational and preventive measures to reduce OT in Iran.

Wound size and location affect the prognosis of penetrating ocular injury

BACKGROUND

Ocular trauma is a leading cause of vision loss. Penetrating ocular injury is a major type of open globe injury(OGI), while its epidemiology and clinical characteristics are still uncertain. The aim of this study is to reveal the prevalence and prognostic factors of penetrating ocular injury in the Shandong province.

METHODS

A retrospective study of penetrating ocular injury was performed at the Second Hospital of Shandong University, from January 2010 to December 2019. Demographic information, injury causes, ocular trauma types, and initial and final visual acuity(VA) were analyzed. To obtain more precise characteristics of penetrating injury, the eye global was divided into three zones and analyzed.

RESULTS

Among 210 OGI, there are 83 penetrating injuries which account for 39.5% of all. In addition, the final VA of 59 penetrating injuries recovered to 0.1 or better, which possesses the highest frequency among OGI. In order to research the relationship between the wound location and the final VA, we took 74 cases of penetrating injuries without retina or optic nerve damage for analysis. Results show that 62 were male and 12 were female. The average age was 36.01 ± 14.15. The most frequent occupation is the worker followed by the peasant. Statistics show that there is an obvious deviation in the Ocular trauma score (OTS) predicting the final VA and the actual final VA in the 45-65 score group (p < 0.05). Results suggest that the commonest penetrating injury zone is zone III (32 cases, 43.8%). Zone III, which is farthest from the center of the visual axis, has the largest improvement of the final VA (p = 0.0001). On the contrary, there is no statistical difference in the visual improvement in zone I and zone I + II that involves the injury of the central visual axis.

CONCLUSION

This study describes the epidemiology and clinical characteristics of patients hospitalized for penetrating ocular injury without retina damage in Shandong province. It can be concluded that larger size and closer location to the visual axis of damage are accompanied by worse prognosis improvement. The study provides a better understanding of the disease and enlightenment for the prediction of visual prognosis.

Clinical and Social Features of Patients with Eye Injuries Admitted to a Tertiary Hospital: A Five-Year Retrospective Study from Crete, Greece

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.

Work-related ocular trauma in the United States: a National Trauma Databank study

PURPOSE

This study aims to investigate trends and risk factors associated with work-related ocular injuries occurring in adults aged 19-64 using the National Trauma Databank (NTDB).

METHODS

In this retrospective, cross-sectional study, the NTDB was used to collect all patients with an ICD-9 code of work-related ocular trauma from 2007 to 2014. Demographic data and risk factors collected included age, gender, race, setting, machinery, and mechanism. Descriptive statistics, univariate, and logistic regression multivariate analyses were conducted.

RESULTS

Between 2007 and 2014, 234,983 cases of work-related trauma were identified, of which 11,097 (5.7%) cases involved ocular trauma. The mean age of patients was 40.7 years (SD = 12.2), and the majority of patients (93.7%) were male. Most injuries occurred in an industrial facility, and the most common injuries were orbital floor fractures (OFFs), ocular contusions, open wounds to the adnexa, and open globe injuries (OGIs). OFFs most commonly involved a concurrent fracture of another facial or skull bone. Male gender (RR = 1.22; CI 1.09-1.38), accidental falls (RR = 1.50; CI 1.41-1.60), trauma from falling objects (RR = 1.34; CI 1.21-1.48), involvement in an unarmed fight (RR = 1.63; CI 1.39-1.91), assault by a blunt object (RR = 1.59; CI 1.31-1.91), and injury caused by animals (RR = 1.63; CI 1.30-2.02) were risk factors for OFFs. Patients with OFFs were less likely to have a concurrent OGI (RR = 0.27; CI 0.23-0.32). On the other hand, injuries occurring in industrial facilities (RR = 1.29; CI 1.11-1.51) and injuries with a loose foreign body striking the eye or adnexa (RR = 1.54; CI 1.28-1.84) were risk factors for OGI. The most common causes of work-related ocular trauma were accidental falls, motor vehicle accidents, and accidentally being struck in the eye. The mean length of hospital stay was 6.56 days (SD = 10.82); 36.7% of patients required ICU admission, and the overall in-hospital mortality rate was 2.8%.

CONCLUSION

The majority of work-related ocular trauma occurred in men, most commonly in industrial locations. Accidental falls were the most common identified cause of trauma. OFF was the most common ocular injury; 80% of OFF cases involved additional facial and skull fractures. Patients with OFFs were less likely to have a concurrent OGI compared with patients without OFFs.

Retina-sparing suprachoroidal intraocular foreign body resulting in cyclodialysis cleft

Purpose

Suprachoroidal intraocular foreign bodies (IOFBs) are an exceedingly rare manifestation of ocular trauma. Here we present a unique case of a metallic wire tracking from the cornea through the suprachoroidal space, and remarkably sparing the retina and lens. The patient attained an excellent visual outcome after management of resultant cyclodialysis cleft.

Observations

A 34-year-old male experienced a penetrating IOFB while operating a rotary wire brush. He presented to the emergency department where posterior involvement of the IOFB was confirmed on CT scan. He underwent emergent pars plana vitrectomy, during which the IOFB was found to be located underneath intact retina and choroid on scleral depression. The wire was removed through the entry wound, which was self-sealing. At follow up, intraocular pressure was 3 mmHg with findings of hypotony. A cyclodialysis cleft was confirmed with ultrasound biomicroscopy. Cycloplegic and photocoagulation treatments were attempted, but ultimately direct cyclopexy was performed to successfully repair the cleft. One year after the initial incident, visual acuity is 20/25 and IOP is 17 mmHg.

Conclusion and importance

Cyclodialysis cleft is a rare sequela of penetrating ocular injury. Clinicians should consider the presence of a cyclodialysis cleft in the setting of postoperative hypotony and confirm either with gonioscopy or other anterior segment imaging methods. Despite failure of conservative therapies, our patient had an excellent visual outcome following surgical closure of the cleft.

Characteristics of work-related eye trauma in construction and manufacturing industries

CLINICAL RELEVANCE

Knowledge of work-related eye trauma in the construction and manufacturing industries will facilitate planning of policies and practices to protect against such occurrences.

BACKGROUND

The aim of this study was to compare demographic, epidemiological, and clinical characteristics of work-related eye trauma in workers in the construction and manufacturing industries.

METHODS

Medical board disability reports of subjects who experienced work-related eye trauma were investigated in this retrospective comparative study. Subjects were separated into two groups - construction and manufacturing - and the demographic, epidemiologic, and clinical characteristics within the two groups were compared.

RESULTS

The construction group included 138 eyes of 132 subjects and the manufacturing group included 82 eyes of 77 subjects. Demographic characteristics of the groups were similar (p > 0.05). The number of work-related eye trauma incidents was found as decreased during winter in construction (p < 0.001), but a similar trend was not found in manufacturing (p > 0.05). Head traumas as reason for work-related eye trauma (p < 0.001), and concomitant systemic diseases including bone fracture and traumatic brain injuries (p < 0.001 and p = 0.012) were significantly associated with eye trauma in manufacturing. Open globe injury was more common in construction (p = 0.046), and chemical injury was more common in manufacturing (p < 0.001). Retinal detachment was more prevalent in construction (p = 0.042). Hand motion or worse final visual acuity was more prevalent in manufacturing (p = 0.007) and the final visual acuity better than 6/60 was more prevalent in construction (p = 0.045).

CONCLUSION

Chemical injuries are more common in manufacturing, whereas open globe injuries and retinal detachments occur more frequently in construction. Permanent low vision and blindness are more commonly associated with work-related eye trauma in manufacturing.

Miniscleral Contact Lens in Pediatric Age Group: Indications, Safety, and Efficacy

OBJECTIVE

To report indications, fitting feasibility, and safety of miniscleral design (MSD) lenses in children.

METHODS

Medical records of patients aged <18 years at the time of referral to Contact Lens Clinic of Farabi Eye Hospital, because of inadequate spectacle-corrected visual acuity, rigid gas-permeable or soft contact lens intolerance, and ocular surface disease were reviewed. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), best-corrected vision with the lens (CCVA), lens parameters, and comfortable daily wearing time (CDWT) were documented.

RESULTS

Seventy-two eyes of 52 pediatric patients were fitted with MSD lens over a 9-year period. The indications for MSD lens fitting were keratoconus (29 eyes), corneal scarring from ocular trauma (16 eyes), ocular surface diseases (25 eyes), and postkeratitis corneal scar (2 eyes). The average UCVA and the mean difference between CCVA and BSCVA were 1.20 and 0.55 logarithm of the minimal angle of resolution, respectively, which shows statistically significant improvement. This significant increase in vision was even seen in those who were referred for the management of ocular surface diseases. The mean CDWT for most patients was 10 hr/day.

CONCLUSION

Miniscleral design lens can be used as a safe and helpful modality to provide good vision and comfort in children experiencing ectatic disorders, traumatic corneal scars, and ocular surface diseases.

Occupational Eye Injuries in the agricultural settings: a retrospective study from North-Eastern Italy

Background: Occupational Eye Injury (OEI) represents a common world-wide event accounting for between 3.3% and 6.1% of all occupational compensation claims. In this retrospective study we evaluated all the recorded OEI which occurred in the Autonomous Province of Trento (APT) during the period 2000-2013. Methods: Data on OEI for all of APT were retrieved an institutional archive and the analysis included demographics of the injured, as well as characteristics and settings of the OEI. In order to assess the risk of OEI in Agricultural Workers (AWs) vs. all other Occupational groups, a multivariate analysis was eventually performed through a logistic regression analysis. Results: A total of 141,139 work-related injuries were recorded, including 5,065 (3.6%) OEI. 91.9% of all cases occurred in males, of Italian origin (77.2%), with a mean age of 38.4±11.7 years. The industrial sector reported the higher share of OEI (70.7%), whereas higher incidence rates were reported among AWs (6.04 vs. 3.85/1,000 workers/year). Agricultural OEI occurred in older workers (45.6±13.3 vs. 37.1±11.0 years), being more likely associated with “contusions” (OR 2.042, 95% 1.602-2.602) and “lacerations” (OR 2.386, 95%CI 1.877-3.033), and less frequently with exposures to chemicals, gases and vapours (OR 0.478, 95%CI 0.279-0.817). Conclusions: Despite a relatively low frequency of OEI, AWs were affected with a seemly higher incidence than that reported in other occupational groups. OEI in AWs exhibited a specific pattern, both in terms of lesion, and settings of the events, recommending tailored interventions in order to improve promotion strategies. (www.actabiomedica.it)

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.

Epidemiological Characteristics of Work-Related Ocular Trauma among the Carpenters in Medan, Indonesia

BACKGROUND

Medan is the capital of North Sumatera Province and the most industrialised area of North Sumatera. One of the largest industries in Medan is the wooden industry. Ocular trauma is often happened in Medan and causes a serious problem.

AIM

This study aimed to analyse the correlation between ocular trauma among the carpenters and the using of eye protection during work and educational level.

METHODS

This study is conducted among the carpenters that work in the wooden industry. There were 30 carpenters that being observed about age, educational level and working hours and the using of eye protection during work that might be related to ocular trauma. All carpenters completed a comprehensive examination and interview.

RESULTS

The most common age range of ocular trauma was between 26-45 years (56.7%), and all were male. Most of the traumatised carpenters educational level had a higher educational level (50%), and workers that had traumatised works more than 8 hours a day (66.7%). From this study, there was a significant correlation between ocular trauma among the carpenters and age (p = 0.047), and working hours (p = 0.039).

CONCLUSION

No significant correlation between ocular trauma among the carpenters and the using of eye protection during work (p = 0.464), and educational level (0.925) was found. Furthermore to anticipate the high rate of worked-related ocular trauma required labour regulations that cover the age of recruitment workers and working hours a day. Work safety regulation protects the workers from work-related ocular trauma.

Validation of a modified Birmingham Eye Trauma Terminology classification for mechanical eye injuries

Introduction

Criticisms have been levelled at the widely accepted Birmingham Eye Trauma Terminology (BETT) classification of mechanical ocular trauma, as it is not specific enough. Alternative modifications to the BETT have been proposed and this study aimed to assess these newer classifications.

Methods

A prospective cohort study of all patients presenting to the outpatient department between January 2005 and December 2014, who were examined and categorised based on the BETT. Cases which did not comply with the BETT system were placed in additional categories, and documented for each type of injury.

Results

A total of 4721 eyes suffered mechanical injuries and 1060 (22.4%) could not be classified with BETT, including 368 globe injuries (7%) associated with orbital/ocular adnexa injury; 692 eyes (14.6%) with ocular surface foreign body (OSFB) or ocular wall foreign body (IWFB). There were 77 eyes (1.6%) with contusion, 9 eyes (0.19%) with lamellar laceration-associated OSFB or OWFB, 29 eyes (0.6%) with globe rupture-associated OSFB, OWFB or intraocular foreign body (IOFB) and 60 eyes (1.4%) with laceration-associated OSFB or OWFB.

Conclusion

The BETT needs modification to be fully applicable to the wide range of ocular trauma seen across the world.

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.

Demographic Characteristics and Clinical Outcome of Work-related Open Globe Injuries in the Most Industrialised Region of Turkey

Objectives:

To evaluate demographic characteristics and clinical outcomes of work-related open globe injuries in the most industrialized region of Turkey.

Materials and Methods:

The demographic and medical records of patients with work-related open globe injuries who presented to the ophthalmology or emergency departments with an official occupational accident report were retrospectively reviewed. Visual acuity categories were defined according to the World Health Organization. The injury types and zones of the open globes were classified according to Birmingham Eye Trauma Terminology System.

Results:

Among 479 patients with work-related eye injuries in 5 years, there were 102 eyes of 101 patients with open globe injuries (21%). The mean age of the patients was 34.5±8.9 years with a mean follow-up of 12.5±12.6 months. The injuries peaked in June in the hour between 12:00 and 13:00. Eighty-six percent presented to emergency services within 12 hours after the injury. Twenty-two percent of the patients had been wearing protective eyewear at the time of injury. The open globe injuries were penetrating in 51%, intraocular foreign body in 40%, rupture in 7% and perforation in 2% of the eyes. The most frequent finding was traumatic cataract. Final visual acuity of 33.3% of patients was below 3/60. Seventy-eight percent of patients that had visual acuity worse than 6/18 at presentation had visual acuity of 6/18 or better at final visit. Sixty-three percent of eyes which had injuries involving all 3 zones resulted in phthisis bulbi, enucleation or evisceration.

Conclusion:

Work-related open globe injuries may have severe consequences such as visual impairment and blindness among the young male working population in industrialized areas. Nearly half of the occupational open globe injuries resulted in visual impairment and blindness.

Epidemiological Characteristics of Work-Related Ocular Trauma in Southwest Region of China

Purpose: To determine the epidemiological characteristics of work-related eye injury in representative southwest region of China. Methods: Patients with eye injuries treated at the Ninth People’s Hospital of Chongqing from 1 January 2014 to 31 December 2014 were included in the current study. All patients completed a comprehensive examination and interview. Demographic characteristics and injury details were recorded. The International Classification of Diseases (ICD-10) and Birmingham Eye Trauma Terminology (BETT) were used. Results: The average age of eye injury patients was 37.52 years and the majority were male. Among the 1055 total patients, approximately 42.9% of the injuries were work-related. The highest proportion of occupational eye trauma was observed in the group between 36 and 45 years of age. Occupational ocular trauma occurred more frequently in summer, with most from 16:00 to 18:00. Metal was the most common injury cause. Foreign body on external eye was the most common diagnosis. Workers in the manufacturing industry without pre-work safety training or eye protection were far more likely to suffer from occupational ocular trauma than those with training and protection. Conclusions: This study provides insight into the epidemiological characteristics of occupational ocular trauma in southwest region of China. The current findings might be considered as a baseline for future research on regional work-related eye injuries. Our findings will provide valuable information for further development of preventive strategies.

Causes and characteristics of work-related eye injuries in western Turkey

OBJECTIVES

To analyze descriptive data and characteristics of work-related eye injuries (WREI) admitted into the emergency department (ED) and obtain information to utilize in planning measures to prevent WREI.

MATERIALS AND METHODS

This prospective study recruited patients with WREI admitted to the center in the two-year study period. Only the casualties occurred at the workplace and while working constituted the sample. The data were collected via face-to-face contact in the ED.

RESULTS

Males comprised the majority of the sample (95.3%, n = 778) and mean age of the patients was 28.1 ± 6.5 (range: 15-54) with the biggest percentage in between 25 and 34 years of age (46.2%, n = 377). Most patients were working in the metal and machinery sectors (66.4%, n = 542). Nearly half of the patients had less than 1 year of experience (50.4%, n = 411). The most common mechanism of WREI was noted to be exposures to welding light (26.9%, n = 219), followed by drilling/cutting injuries (21.1%, n = 172). "Carelessness" and "hurrying up" were the most commonly reported causes of WREIs among 'worker-related causes' (21.4% and 16.1%, respectively). Lack of protective measures ranked the highest among workplace-related causes (18.7%, n = 207).

CONCLUSIONS

Programs to increase awareness on workplace safety and sound preventive strategies for both parties-employers and employees are to be pursued. Occupational safety efforts should include training on workplace eye safety and campaigns to raise knowledgeability on this disease among workers.

Olive-harvesting eye injuries

Purpose:

To document the types of ocular trauma that occurs during the olive-harvesting season in a region of the Middle East.

Materials and Methods:

Ophthalmic assessments of all patients were performed by one ophthalmologist. Examinations included visual acuity, slit-lamp evaluation of the anterior segment, intraocular pressure measurement and posterior segment assessment after pupil dilatation.

Results:

The study cohort comprised 119 patients who presented for ocular injury due to olive harvesting. Seven patients (5.9%) had severe ocular trauma. Two of these patients presented with corneal perforation, and five with retinal edema. Six patients with severe ocular injury were male.

Conclusions:

Ocular injuries are common when olives were harvested manually or with sticks. A preventive program to reduce injury should consider environmental and cultural factors.

Increasing compliance with protective eyewear to reduce ocular injuries in stone-quarry workers in Tamil Nadu, India: a pragmatic, cluster randomised trial of a single education session versus an enhanced education package delivered over six months

OBJECTIVE

To evaluate the efficacy of standard education versus enhanced education in increasing compliance with protective eyewear to prevent ocular injuries in stone-quarry workers.

DESIGN

Pragmatic, allocation concealed, participant and outcome assessor blinded, cluster randomised trial.

SETTING

Six stone-quarries around Vellore, Tamil Nadu, South India.

PARTICIPANTS

204 consenting adult stone quarry workers.

INTERVENTIONS

Protective eyewear plus enhanced education (one education session, plus 11 sessions of group education, individual discussions, and educational plays over six months) versus protective eyewear plus standard education (one education session and 5 follow up visits).

OUTCOMES

The primary outcomes were observer-rated compliance with protective eyewear and reduction in incidence of ocular injuries (slit-lamp examination by an observer blinded to allocation status) at three and six months. Analysis was by intention to treat.

RESULTS

Quarries and participants were similar at enrolment. All quarries; 92/103 (90%) of workers in three quarries given enhanced intervention, and 91/101 workers (89%) in three quarries given standard education, completed six months follow up. Compared to standard education, enhanced education significantly increased compliance with protective eyewear by 16% (95% CI 3-28%) at three months (OR 2.1; 95% CI 1.2-3.8); and by 25% (95% CI 11-35%) at six months (OR 2.7; 95% CI 1.5-4.8). Protective eyewear and enhanced education reduced the incidence of eye injuries at three months by 16% (95% CI 7-24%); and standard education by 13% (95% CI 4-22%), compared to the three months before interventions. The cumulative reduction over baseline in eye injuries at the six months was greater with enhanced education (12% decrease; 95% CI 3-21%) than with standard education (7% decrease; 95% CI 17% decrease to 3% increase). However, this incidence did not differ significantly between intervention arms at three months (OR 0.7% 95% CI 0.3-2.1); and at six months (OR 0.8; 95% CI 0.4-1.5).

CONCLUSION

Provision of appropriate protective eyewear reduces the incidence of eye injuries in stone-quarry workers. Periodic educational and motivational sessions with individuals and groups facilitates sustained use of protective eyewear.

Pattern of pediatric eye injuries in Tehran, Iran

Childhood ocular trauma is a preventable cause of visual impairment and blindness worldwide. This prospective study was conducted to explore the profile of eye injuries in pediatric patients referring to a tertiary eye center in Tehran, Iran. Six hundred consecutive pediatric patients aged 17 or less who presented to emergency department of Farabi Hospital were enrolled. Age and sex of pediatric patients, time of trauma, time between trauma and presentation, place of injury, etiology of eye injury, visual acuity, and type of injury based on Birmingham Eye Trauma Terminology were collected. Mean (±SD) age of cases was 7.9 ± 4.8. Male to female ratio was 2.3:1. More than 70 % of the patients presented less than 12 h after ocular trauma. Most injuries occurred at home (57.7 %) followed by street (20.3 %). Twelve patients had visual acuity lower than 0.1 at initial visit. Projectile trauma was the most common cause (35.8 %) followed by blunt trauma (33.3 %). 86.3 % of traumatic events consisted in closed globe injuries. Parents should be involved more effectively in care and supervision of their children especially for boys, at home and on holidays.

Missing X and Y: a review of participant ages in population-based eye studies

Ophthalmic population-based studies have been used to establish the frequency of eye disease and the associated environmental and genetic factors that cause vision impairment and blindness. Most of these studies have concentrated on the diseases of ageing: cataract, age-related macular degeneration, glaucoma and diabetic retinopathy. Other studies have identified eye diseases in children but few studies of young adult eye disease exist. We conducted a systematic review of the ophthalmic literature to identify potential population-based eye studies and then note the age of participants in the studies. We then summarized the disease specific to young adults to show there is a need for further research to identify eye disease in this important and often-neglected group in the community. Eighty-four large population-based studies have been conducted worldwide: 9 in North America, 2 in South America, 17 in Africa, 35 in Asia, 11 in Australia and the Pacific, 6 in Europe, 4 in the Middle East and 1 that covered 3 continents. No studies specifically examined young adults. Twenty-six per cent of studies included young adults as part of all ages examined but none of these examined a large number of young adults.