Predictive factors of visual outcome in open globe injuries in Thailand: a prospective study

Abstract

Background: Eye injuries, especially open globe injuries, cause visual morbidities and socioeconomic burden. It is an urgent task to require good database and stakeholder involvement for open globe injuries.Objectives: Investigate the epidemiology and predictive factors of visual outcome in open globe injuries in an industrial area in Thailand.Methods: Consecutive cases of in-patient open globe injuries in Mettapracharak Eye Centre between February 2009 and January 2010 were examined. Patients were interviewed at first visit and followed-up for six months. The Birmingham Eye Trauma Terminology was used to classify types of injuries. Demographic data, cost of treatment, length of stay, and predictive factors (initial visual acuity, presence of relative afferent pupillary defect, hyphema, vitreous hemorrhage, intraocular foreign bodies, retinal detachment, time-duration to surgery, and wound length) were assessed.Results: Fifty-two out of 60 eyes were included. Most (82.7%) of patients were men and average age was 34.1 years (range: 8-68 years). About half (51.9%) were graduated from primary school and 65.3% were laborers. Most patients had not used protective devices. The endophthalmitis rate was 13.5%, and panophthalmitis rate was 5.8%. The enucleation rate was 9.6%. The median length of stay was nine days. Poor initial visual acuity and intraocular foreign bodies were significant predictive factors (p <0.05).Conclusion: Open globe injuries caused visual morbidity especially in young adult male, laborers with low education. Initial visual acuity and intraocular foreign bodies were significant predictive factors.

Epidemiology of Pediatric Open Globe Injuries in a University Hospital in Thailand

“…The variability among age groups may be the result of the differences in nurturing, lifestyle, and caregiver’s education. Our study also demonstrated that injuries in children majorly arose at home (67.4%), as opposed to adults whose injuries commonly occur at a workplace [ 4 , 8 ]. Interestingly, only 17.4% of the children’s eye injuries in our study happened at school despite children spending more time at school than at home, similar to the result of Sul et al [ 6 ] and Tok et al [ 10 ] that showed most of the injuries occurred at home and there were a little number of the injuries at school (4.4% and 8.5%, respectively).…”

“…Previous studies also found several prognostic factors that affected the final visual acuity (VA), including age, initial VA, wound location, wound size, and coinciding injuries, such as vitreous hemorrhage (VH), retinal detachment (RD), and endophthalmitis [ 3 - 6 ]. There are a few studies in the literature reporting the characteristics, visual outcome, and prognostic factors of open globe injuries in Thailand [ 8 , 9 ]; only the study by Choovuthayakorn et al reported these in children from northern Thailand [ 9 ]. The epidemiology and characteristics of these patients could be different depending on geographical locations.…”