Abstract
Purpose :
To determine the spectrum of open globe injuries presenting at tertiary referral centres located in Singapore, India and the United States. Data was obtained from the International Globe and Adnexal Trauma Epidemiology Study (IGATES) database. The overall aim of IGATES is to develop a standardised language about ophthalmic trauma. This analyses is a first step in determining its validity and efficacy, ahead of a broader rollout internationally in the future.
Methods :
A retrospective review of 213 cases of ophthalmic trauma presenting between 2010 – 2018 was conducted. All patients with open globe injury regardless of the presence of concomitant adnexal or orbital injury were included. Injuries were classified in accordance to the Birmingham Eye Trauma Terminology System (BETTS). Data regarding patient demographics, type of open globe trauma, location and activity at time of injury, presenting visual acuity and subsequent operative management were collected via a standardized questionnaire and based on the clinical records of the respective institutions.
Results :
213 cases of open globe injury were included with a mean age of 32.12 years. 188/213 (88.3%) were male and 25/213 (11.7%) were female. The majority of cases were penetrating injuries (64.3%) and globe ruptures (19.7%). The highest incidence of injury occurred at the workplace (41.3%) and at home (33.8%). In 61/213 (28.6%) of cases injuries occurred in spite of the use of eye protection, while usage of protective eye gear was absent or undocumented in 152/213 (71.4%) cases. The presenting best correct visual acuity (BCVA) was worse than 6/60 in 156/213 (73.2%) of cases, and unable to perceive light (NPL) in 16/213 (7.5%). 208/213 (97.6%) patients subsequently underwent surgery following the initial presentation. 25/213 (17.8%) of cases had a concomitant eyelid laceration, while 2/213 (0.9%) also sustained damage to the lacrimal drainage apparatus.
Conclusions :
Ophthalmic trauma is a leading cause of monocular blindness. This study shows that the majority of open globe injuries occurred in young, male subjects and most often occur at the workplace. The epidemiological data gathered may be essential in guiding policies aimed at reducing occupational risk of ocular injury. Future studies from the IGATES database will aim to investigate prognostic factors for final visual outcomes in open globe injury.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.