Post-traumatic endophthalmitis ☆

Purpose: To analyze the epidemiology and clinical characteristics of serious eye injuries leading to legal blindness. Methods: Analysis of information on 11,320 eyes in the United States Eye Injury Registry (USEIR) database. Legal blindness in this study was defined as visual acuity of worse than 20/200. Results: No less than 27% of eyes with serious injury had < 20/200 final vision, although the rate varied greatly with injury type. Several risk factors were found to statistically significantly increase the chance of eye trauma resulting in blindness: age over 60 years, injury by assault, sustained on street/highway, or occurring during fall or by gunshot. Trauma to the left eye carried a statistically significantly poor prognosis as did two injury types, rupture and perforating. Involvement of the posterior segment was another factor indicating poor outcome; in particular, vitreous hemorrhage, retinal detachment, choroidal rupture, and endophthalmitis were found to increase the risk of blindness. Conver...

Epidemiology of blinding trauma in the United States Eye Injury Registry.

Objective To present the descriptive epidemiology of emergency department–treated eye injury in the United States. Methods Data from the Consumer Product Safety Commission’s National Electronic Injury Surveillance System All Injury Program was used to estimate the number of patients treated in US emergency departments for eye injuries. Eye injury rates were calculated according to age, sex, and race, and characteristics of the injury event were determined. Results The rate of emergency department–treated eye injury in the United States is 3.15 per 1000 population (95% confidence interval, 2.66-3.63). Rates were highest among those in their 20s and 30s, among males, and among American Indians and African Americans. The majority of injuries occurred in the home, and contusions and abrasions were the most common types of injury. Conclusion This study documents the burden of eye injury in the United States and identifies areas wherein future research activities should be directed.

https://jamanetwork.com/journals/jamaophthalmology/articlepdf/417029/eeb30077.pdf

Incidence of emergency department-treated eye injury in the United States.

OBJECTIVE: An estimated 2.4 million eye injuries occur in the United States each year, with nearly 35% of injuries among persons aged 17 years or less. Although previous research has identified some of the characteristics of pediatric eye injuries, many studies focused only on a specific patient population or type of eye injury or relied on self-reported data. In addition, little information has been reported on the total charges associated with treating pediatric eye injuries. Using a large national database, our aim was to examine hospitalizations for the treatment of pediatric eye injuries in the United States, including the demographic, medical care, and financial characteristics associated with major categories of eye injury. METHODS: Cross-sectional data were derived from the 2000 Kids' Inpatient Database of the Healthcare Cost and Utilization Project. Eye injury-related hospitalizations were identified by using International Classification of Disease, Ninth Revision, Clinical Modification codes. Discharges were selected if the eye injury was the principal or secondary diagnosis. Guidelines from the Centers for Disease Control and Prevention were used to group external-cause-of-injury codes into broader categories to allow meaningful comparison with previous studies. The reported charges for the treatment of eye injuries and the expected primary payer were determined. Cases were statistically weighted to produce national estimates of hospitalizations for pediatric eye injuries and to determine the characteristics of these injuries. RESULTS: Data were collected by the Kids' Inpatient Database for 3834 actual eye injury-related hospitalizations. These records represent an estimated 7527 eye injury-related hospitalizations among children aged 20 years or less in the United States during 2000. Inpatient charges for the treatment of these injuries were more than $88 million. The rate of hospitalization for pediatric eye injuries in the United States in 2000 was 8.9 per 100,000 persons aged 20 years or less. Young adults aged 18 to 20 years accounted for the highest percentage of hospitalizations (23.7%). Males accounted for 69.7% of hospitalizations. A majority of hospitalizations were for open wounds of the ocular adnexa. Motor vehicle crash was the most common cause of injury, followed by being struck by or against an object and being cut or pierced. CONCLUSIONS: These findings illustrate the considerable morbidity, financial burden, and proximal causes for pediatric eye injury-related hospitalizations. Our data support the need for eye injury prevention efforts that consider the age, gender, and developmental stage of children. Educating parents and children about the potential for eye injuries at home and during hazardous activities is an important public health goal. In addition, promoting the use of appropriate protective eyewear by children during activities with a high risk of ocular trauma will help prevent future eye injuries. Language: en

Pediatric eye injury-related hospitalizations in the United States.

Objective To describe the epidemiology of ocular trauma in children 15 years and younger who underwent evaluation during a 5-year period in the emergency department of a tertiary referral center in northeastern Colombia. Methods We retrospectively reviewed the medical records of children 15 years and younger. Records of 393 children with 415 incidents of eye injury were included in the study, of whom 22 were initially treated for bilateral ocular trauma. Results Most patients (64.9%) were boys. The highest proportion of injuries(44.4%) occurred at home, followed by streets and roads (28.6%). Blunt (35.1%) and sharp (22.6%) objects represented the most frequent causes of trauma. Closed-globe injuries were far more frequent than open-globe injuries for boys (82.4% vs 17.6%) and girls (83.8% vs 16.2%). Of those with closed-globe injuries, 253 injuries (80.0%) registered an initial visual acuity of greater than 20/60, whereas 31 open-globe injuries (52.5%) registered an initial visual acuity of less than 20/400. Most closed-globe injuries (223 [92.1%]) did not cause any final visual impairment in the affected eye, whereas 26 open-globe injuries (55.3%) caused severe visual impairment or blindness. Conclusions Most of the accidents reported in this study could have been avoided; the data demonstrate a clear need for primary prevention and control measures.

https://jamanetwork.com/journals/jamaophthalmology/articlepdf/415755/eeb20036.pdf

Epidemiology of childhood ocular trauma in a northeastern colombian region

· Background: Trauma remains a major problem throughout the world. The prognosis of severe eye injuries is commonly bleak. This paper focuses on the epidemiology of eye trauma, the role of ocular epidemiology, and identification and reduction of risk factors. · Methods: An analysis of the first 8,952 patients reported with severe eye injuries, defined as those eye injuries resulting in permanent and significant (measurable and observable on routine eye examination) structural and/or functional changes to the eye, from the United States Eye Injury Registry as of 31 July 1998. · Results: The age of patients entered was from the 1st year of life to 103 years. Fifty-eight percent of those injured were less than 30 years of age. The male to female ratio was 4.6:1, reaching 7.4:1 in the fourth decade of life. Almost half of the injuries involved the retina, and 77% of the injured eyes required one or more surgical procedures, including a large proportion which have undergone vitreoretinal surgical procedures. · Conclusion: Injuries remain the most serious public health problem facing developed nations. Yet, a persistent inadequacy exists both in the standardized documentation of eye injuries and in their treatment. With appropriate surgical and medical intervention, a majority of the reported injured eyes recovered functional levels of visual acuity. It appears that glasses, including prescription glasses and even non-prescription sunglasses, can offer measurable protection which results in a lower incidence of severe eye injuries to those wearing glasses.

G. P. Matthews

Papers

The epidemiology of serious eye injuries from the United States Eye Injury Registry.