Intimate Partner Violence: an important etiology to identify in patients with open globe injuries

Abstract

Purpose : To evaluate the prevalence and outcomes of open globe injuries resulting from acts of intimate partner violence in a large population of patients presenting with open globe injuries at Massachusetts Eye and Ear.

Methods : 390 consecutive open globes were reviewed at Mass. Eye and Ear, a single large tertiary ophthalmology trauma hospital, between the years of 2013 and 2016. 8 patients reported open globe injury related to intimate partner violence. Visual acuity, mechanism of injury, secondary injuries, initial and secondary operative reports, and complications were recorded and reviewed.

Results : 390 open globes presented to MEEI between the years of 2013 and 2016. 8 patients reported open globe injuries related to intimate partner violence with one patient presenting with bilateral open globe injuries (total 9 eyes or 2.3% of open globe injuries). All patients were female. Average age was 41 (age range 27-76 with all but one between 25-50 years old). 7 patients disclosed the relationship of the perpetrator and the mechanism of injury on initial evaluation. Visual acuity on presentation ranged from CF to NLP (with 6 of 9 eyes NLP on presentation). Mechanism of injury included blunt trauma in 3 patients and penetrating trauma in 5 patients. Four patients had associated orbital fractures and one patient had multiple other facial fractures. Four patients had facial lacerations requiring repair. All eyes underwent initial exploration and 8 out of 9 eyes were closed primarily. Two eyes underwent secondary enucleation (total 3 eyes). Three eyes required secondary vitrectomy. The best final visual acuity was 20/200 in two eyes and count fingers in one eye. 6 of 9 eyes remained NLP.

Conclusions : Ophthalmologists evaluating and treating open globe injuries should be aware of the potential etiology of intimate partner violence and should be prepared to screen for these cases. Often open globe injuries from intimate partner violence result in severe vision loss, only adding to the psychological impact of the assault. Patient safety should be immediately assessed and the appropriate referrals placed to adequately support the patient.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.