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Evan Newbolt, Charles Chen, John Nguyen, Jennifer Sivak-Callcott, Brian Ellis, Chad Bingham; Ocular and adnexal injuries in patients with all-terrain vehicle accidents in West Virginia. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4437.
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To evaluate the demographics of patients in ATV accidents, determine the type and extent of the ocular and adnexal injuries sustained, identify risk factors associated with ATV accidents, and compare initial and final visual acuities of these patients.
A retrospective chart review was performed on 3,012 patient charts in the West Virginia University ophthalmic trauma database and electronic medical record to identify patients with ophthalmic injuries related to ATV accidents from July 2002 - June 2012. Patients were included in the study if sufficient documentation was available.
One hundred fifty-five patients were identified. The patients' age ranged from 3-80 years (mean, 33.4 years). Only eleven patients (7.5%) were wearing a helmet. One hundred twenty-five patients (81.7%) were admitted to the hospital. The average length of stay was 6.4 days. Two patients died from severe intracranial injuries. 53% of patients tested positive for alcohol, while 49% were found to be under the influence of other illicit drugs. The most common ophthalmic injury was orbital fracture (130 patients). Forty-eight patients (37%) required fracture repair. Eleven patients (7%) were noted to have a visual deficit prior to the accident. Not including enucleation (4 patients, 4 eyes), the final visual acuities were found to be similar to the initial visual acuities.
Ocular and adnexal injuries due to ATV accidents are relatively common in West Virginia. These injuries vary widely in severity, ranging from minor abrasions to complex fractures and open globe injuries. Orbital fractures are the most frequent complication of these accidents. Fortunately, only a small minority of patients have severe visual loss. Failure to wear a helmet and the use of alcohol and/or illicit drugs are repeatedly identified as risk factors for injury. The presence of a visual deficit prior to the accident may be a risk factor not previously described.
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