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Niranjani Nagarajan, Krisztian Sebestyen, Varshini Varadaraj, Fasika Woreta, Bonnielin K Swenor, Joseph K Canner; Trends in ocular trauma-related emergencies and hospitalizations in the U.S. over three decades. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5150.
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Ocular trauma is a leading cause of preventable blindness in the United States (US) with an incidence of 3.1 cases per 100,000 population. We examined trends in ocular trauma in the emergency department (ED) and inpatient (IP) hospitalization setting in the US from 1979 to 2014 using two nationally representative surveys.
Analyses included data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) on ocular trauma presenting to the ED (1993 to 2014) and the National Hospital Discharge Survey (NHDS) on ocular trauma-related IP hospitalization (1979 to 2010). We calculated annual rates of a primary diagnosis of ocular trauma using total ED visits and IP hospitalizations, adjusting for survey weights. Using negative binomial regression, we calculated incidence rate ratios (IRR) for ocular trauma related ED and IP visits over time, adjusting for the increase in population over the years.
NHAMCS: A total of 18,836,930 ocular trauma cases presented to the ED from 1993-2014. In 1993, there were 1,040,327 cases declining to 530,860 in 2014 (Figure). The most common presentations were foreign body (227,953 in 1993 vs 107,164 in 2014), contusion (131,353 in 1993 vs 102,235 in 2014), and adnexal open wound (106,719 in 1993 vs 20,984 in 2014). In regression analysis, we found a 5% decline in ocular trauma-related ED visits each year (IRR=0.955, 95% CI=0.947, 0.962).NHDS: There were a total of 770,365 ocular trauma related IP hospitalizations from 1979-2010. In 1979, there were 46,213 hospitalizations, declining to 11,219 in 2010. The most common presentations were contusion (15,666 in 1979 vs 2460 in 2010), eyeball wound (12,021 in 1979 vs 2675 in 2010), and adnexa wound (9883 in 1979 vs 1912 in 2010). The most common causes of ocular trauma were “struck by, or against” (n=89,683), motor vehicle traffic accident (n=41,484), cut/pierce (36,896), and falls (34,967). In regression analysis, we found a 6% decrease in inpatient hospitalization each year for ocular trauma (IRR=0.945, 95% CI=0.939, 0.950)
We noted significant declines in ocular trauma related ED visits and IP hospitalizations. We postulate that an increase in automotive safety and laws, industrial workplace safety laws and public policy in eye injury prevention may be responsible for this decline.
This is a 2020 ARVO Annual Meeting abstract.
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