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J. M. Kanoff, C. M. Andreoli, M. T. Andreoli, A. Turalba; Characteristics and Outcomes of Work-Related Open-Globe Injuries. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5319.
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To evaluate the characteristics and outcomes of patients treated for open globe injuries (OGIs) sustained at work and to compare these results to patients injured outside of work.
Retrospective chart review of 813 consecutive patients with OGIs treated at the Massachusetts Eye and Ear Infirmary (MEEI) between 1999 and 2008. 146 patients with OGIs sustained at work were identified. Their baseline characteristics and outcomes were compared with the rest of the patients in the database. Statistical analysis was performed using either a two-tailed t test or a two-tailed fisher’s exact test where appropriate.
98% of the patients injured at work were men and the average age of the patients was 35.8 years (17-72 years). 60% of patients presented to the MEEI within 6 hours of the injury while 17% took greater than 12 hours to seek medical attention. The most common mechanism of injury was penetrating trauma (56%); 38 patients examined had an intraocular foreign body (IOFB). The average follow-up for these patients was 335 days (1-2681 days). 9 work-related OGIs resulted in enucleation. Compared with the overall globe trauma population, the average follow up (p=0.19) and initial time to presentation (p=0.24) of work-related injuries was no different. There was a higher incidence of IOFB (p=0.0001) and penetrating injuries (p=0.0009) in patients injured at work. Both the preoperative (p=0.0001) and final best-corrected visual acuity (p=0.03) was better in the work-related group. The final visual acuity was better than 20/200 in 82% of cases of work-related OGIs. However, there was no difference observed in the rate of enucleations (p=0.4).
Work-related injuries can cause significant morbidity in a young population of patients. Based on average patient follow-up and final visual acuity, those injured at work do at least as well, if not potentially better than OGIs sustained outside of work. The better visual outcomes of these patients may be a function of the higher rate of penetrating injuries occurring at work. The delay to presentation by some of the patients indicates a possible need for better education or procedures in the workplace for reporting injuries and seeking medical assistance. While the statistically higher rate of IOFB in the work population is not surprising, it does emphasize the importance of strict adherence to the use of eye protection in the workplace.
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