Visual and ocular morbidity in severe open‐globe injuries presenting to a regional eye centre in New Zealand

Abstract

Importance Open‐globe injuries (OGI) are a leading cause of monocular blindness world‐wide with considerable cost to the individual and society. Background To characterize the epidemiology, severity and outcomes of OGI treated at a major ophthalmology centre in New Zealand. Design Retrospective study. Participants A total of 385 eyes of 381 patients over a 10‐year period. Methods Eligible patients were identified using diagnosis and surgery codes on hospital discharge summaries. Clinical notes were reviewed to determine patient demographics, injury details, treatments and outcomes. Main Outcome Measures Complications of injury, visual acuity at 3 months and final follow‐up, and final status of the eye. Results The estimated annual incidence of OGI was 2.8 per 100 000. Working‐age males predominated but age at injury ranged from 9 months to 90 years. Maori and Pacific peoples were over‐represented. Injuries were severe with 58.7% presenting with vision of hand movements or worse. Penetrating injuries (56.4%) were most common, followed by globe ruptures (35.6%). Major complications included retinal detachment (15.8%), enucleation/evisceration (9.1%), phthisis bulbi (9.9%), endophthalmitis (2.6%) and sympathetic ophthalmia (0.26%). Despite the injury severity, 46% of eyes achieved final BCVA of ≥6/12. The Ocular Trauma Score (OTS) was a useful prognostic tool for stratifying severity of injury and predicting visual outcome (Fisher's exact test P < 0.001). Conclusions and Relevance The incidence and severity of OGI in NZ are comparable to global statistics. Surgical repair can effectively recover vision, predicted well by the OTS. We identified at‐risk groups to target with education and prevention strategies.

Open Globe Injury related to Road Traffic Accident: a Retrospective Study

“…Nevertheless, when considering the overall incidence of road traffic-related OGI which attained a 6 poorer visual prognosis compared to closed globe injury, the variation in incidence according to countries has been published [9]. In high-income countries, a low incidence of road traffic accidents has been shown which included a study by Li from US [3,14,15,20,21]. In contrary, a much higher incidence has been reported in a study by Madhusudhan et al (17.6%) from Malaysia and, accordingly, in this study (9.4%) which were both characterized as middle-income countries [12].…”

“…Apart from gender, specific age range has been observed to differ between causes of OGI. In fall down-related OGI, the peak incidence has been described in young children and elderly, while patients between 30 to 40 years were at increased risk for occupational-related OGI [3,4,16,23].…”

“…Previous studies from New Zealand and Singapore estimated the annual incidence of OGI to be 2.8 and 3.7 per 100,000 population [2,3]. There are several etiologies of OGI which have been reported with different characteristics [4][5][6].…”

Open‐globe injuries: A global issue of protection

“…This month's Clinical and Experimental Ophthalmology highlights an untimely, unfortunate and unnerving clinical condition that presents to our busy emergency departments. Court et al wonderfully describe the circumstances surrounding eye injuries and subsequent treatments undertaken to prevent vision loss from the injury in the study “Visual and ocular morbidity in severe open‐globe injuries presenting to a regional eye centre in New Zealand.” Whether the patient suffers an injury following an altercation with another person, power equipment, vehicle or as the result of warfare, the challenges faced remain the same, and the visual outcomes are highly variable and are predicted most characteristically by the injury itself. Despite the small surface area covered by the globe, it is interesting to note the frequency of ocular injuries and the severity the injuries cause.…”

Клініко-Психопатологічні Особливості Пацієнтів З Травматичним Ушкодженням Органа Зору

“…Вступ. Втрата зору є однією з актуальних медичних і соціальних проблем [1][2][3]. За оцінками ВООЗ, у світі налічується 285 млн осіб із порушеннями зору, з них 39 млн сліпих (0,56 % популяції) і 246 млн слабкозорих (3,5 %) [4].…”