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Matthew Jusu Vandy, Jessica Shantha, Steven Yeh; Prevalence of Ocular Injuries at the Connaught Government Hospital in Freetown, Sierra Leone. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5513.
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© ARVO (1962-2015); The Authors (2016-present)
Ocular trauma is a major cause of severe visual impairment and blindness around the world leading to immense impact on the individual, family, and community. Developing countries have different mechanisms of ocular injury. The purpose of this study is to describe the epidemiology of eye injuries in Freetown, Sierra Leone.
Cross-sectional retrospective study at the Connaught Government Hospital in Freetown, Sierra Leone (January - September 2014) Connaught Government Hospital is 1 of 3 tertiary referral centers in Sierra Leone. 927 patient records were reviewed. Demographic data, education status, occupation, causes/mechanisms of injury, place of injury, time of trauma, time of reporting to the hospital, and visual acuity (VA) at presentation and discharge were recorded.
A total of 927 patient’s medical records were reviewed. 53.4% (n=495) were male and 46.6% (n=432) were female. The male:female ratio was 1.2:1. Age ranged from 3 months to 65 years. The highest incidence of eye trauma occurred in the 20–29 age group 32.6% (302 ). 93.2% (n=864) had unilateral involvement. Of these 69.8% (n=603) were left eye, 30.2% (n=261) were right eye. 6.8% (n=63) were bilateral. Causes of eye injury were assault: 71.8% (n=666), flying particle/stone 10.7% (99), fall 3.9% (n=36), chemical 2.9% (n=27), firework 1.0% (n=9), and shell nut 1.0% (n=9). Closed globe injury occurred in 88.3% (n=819) and open globe trauma in 11.7% (n=108). Most patients presented 48 hrs–1 week after trauma 46.9% (n=435). Delayed presentation was common with18% presenting <24 hours and 22% of patients presenting at 24-48 hours (n=204). 13% presented >1 week after injury ( n=122 ). At presentation, VA impairment was normal/mild (6/5-6/18) in 464 (50%), moderate (<6/18-6/60) in 116 (12.5%), severe (<6/60-3/60) in 51 (6%) or legally blind (<3/60-NLP) in 296 (32%) at presentation in affected eyes. At discharge, VA impairment was normal/mild in 695 (75%), moderate in 74 (8%), severe in 19 (2%), and legally blind in 139 (15%) eyes.
Closed globe injury due to aggravated assault was the most common type of eye injury in this cohort. Health promotion programs focusing on violence could potentially decrease ocular injury. The baseline data obtained in this study will be used for strategic planning for interventions to prevent ocular injuries in this at-risk population.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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