Purpose:
To identify epidemiologic trends in open–globeinjuries and types of injuries at risk for poorer outcomes.
Methods:
A retrospective analysis of consecutive patients presentingto the Wilmer Eye Institute with open–globe injuries betweenJanuary 2001 and December 2004. Demographic information, settingand mechanism of injury, initially exam findings, medical andsurgical management and outcome data were collected. Findingswere compared to prior series conducted on open–globeinjuries at the Wilmer Eye Institute
Results:
225 open–globe injuries were identified. Therewas a slight decrease in overall enucleation rates as comparedto prior studies, however, 49% of recent patients had no orvery limited vision (VA < 5/200) at last follow–up.52% of the open–globe injuries were secondary to a rupturemechanism, and this percentage has grown over the last 75 years.Ruptures had poor visual acuity outcomes with 42% of rupturesending with NLP vision, enucleation, or evisceration. Majorcauses of ruptured globes included assaults, accidents, falls,and motor vehicle accidents.
Conclusions:
The percentage of rupture–induced open–globeinjuries has increased at the Wilmer Eye Institute over thepast 75 years, with the majority of current open–globeinjuries secondary to this mechanism of injury. Ruptured globeshave very poor visual acuity outcomes. Assaults, falls, andmotor vehicle accidents have been identified as major causesof ruptured globes and may present an opportunity for interventionand injury prevention.
Keywords: trauma • clinical (human) or epidemiologic studies: outcomes/complications