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Tyler Thomas Miller, Joshua Ong, Shaquille Josue-Coicou Charles, Kunal K. Dansingani; Epidemiological Analysis of Causes of Ocular and Orbital Tissue Contusions Presenting to Emergency Departments Nationwide. Invest. Ophthalmol. Vis. Sci. 2021;62(8):683.
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© ARVO (1962-2015); The Authors (2016-present)
Ocular emergencies related to contusions of the eye & orbit often require immediate attention in the emergency department (ED). This study characterizes the circumstances and age distribution of patients with ocular contusions, highlighting common causes that may be prevented with proper eye protection.
A multi-year analysis of the CDC National Hospital Ambulatory Medical Care Survey (NHAMCS) database from 2011-2017 was conducted. We assessed the burden of contusions of the eye and orbit (ICD-9 921, ICD-10 S05) in the ED setting. Differences in variables across age groups were evaluated using logistic regression, controlling for potential confounders. All analyses were conducted using STATA 16 statistical software.
We analyzed 166,395 emergency visits from 2011 to 2017. There were 297 contusions of the eye and orbit, representing 2,019,365 ocular contusions that had presented to EDs nationwide. Of these, roughly 17.8% were of unknown or not documented cause. The most common documented causes were striking against or accidentally struck by objects or persons (30.2% of injuries), assault (14.1%), falls on steps, level ground, or at sporting events (8.57%), firearm/labor/construction-related injuries (6.24%), and motor vehicle related injuries (5.13%). Injuries secondary to activities that warrant eye protection (firearm/labor/construction) made up a larger proportion of all injuries for adults aged 55-64 (27.7%) and children aged 5-11 (21.5%). Individuals aged 5-11 and 25-34 were 2.7 times (p = 0.005; 95% CI: 1.36 – 5.41) and 2.6 times (p = 0.001; 95% CI: 1.46-4.68), respectively, more likely to visit the ED with a contusion of eyeball and orbital tissues compared to adults who were 65 years and older (Figure 1). Comorbidities, including substance use, were not associated with injuries.
Contusions of the eye and orbit that present to the ED have a wide range of causes. Activities known to warrant eye protection were the 4th most common cause of ocular contusion. Older adults and children were most at risk for preventable injuries, possibly due to decreased visuospatial awareness, disregarding eye protection due to familiarity with occupational equipment, or being too young to acknowledge the importance of eye safety. Individuals of all ages could benefit from education on the importance of eye protection.
This is a 2021 ARVO Annual Meeting abstract.
Figure 1. Ocular Contusions Across Age
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