Abstract
Purpose :
Despite ocular trauma being an important cause of vision loss worldwide, there is currently a lack of consensus on the optimal management for traumatic injuries.
Our objective is to summarize global preferred practice patterns for the management of ophthalmic trauma.
Methods :
An online survey was distributed to 42 trauma centers throughout 6 continents to assess institutional management practice patterns for eye emergencies including open globe injuries, hyphema, and orbital fractures.
Results :
Responses were collected from 32 institutions (response rate 32/42, 76.2%) that were distributed across Asia (37.5%), North America (34.4%), South America (12.5%), Africa (9.4%), and Europe (6.3%). The respondents practiced ophthalmology for a median of 15.5 (IQR 9, 20) years after residency. The majority of institutions (n=24, 75.0%) have ophthalmology coverage 24 hours per day each day; of those that do not, 8 (100%) have on-call ophthalmology coverage available within one hour of notification. Most institutions (n=25, 78.1%) routinely administer pre-operative systemic antibiotics for open globe injuries, while 31.3% (n=10) administer pre-operative topical antibiotics. Oral ciprofloxacin was most preferred for systemic antibiotics (n=5,15.6%), while moxifloxacin was most popular for topical (n=6, 18.8%), but respondents lacked consensus. Around half of the institutions also administer intraoperative antibiotics during the time of open globe injury repair (n=17, 53.1%), while many (n=29, 87.9%) administer topical steroids post-operatively. Regarding hyphema management, 93.8% (n=30) of responding institutions administer topical steroids, with prednisolone as the preferred medication for many (n=29, 90.6%). Respondents also disagreed on the routine disposition for hyphema patients, with 25.0% (n=8) admitting all hyphema patients to the hospital. For patients presenting with orbital fractures, 18 centers (56.3%) give systemic antibiotics to prevent infection, while 9 (28.1%) administer systemic steroids to quell inflammation.
Conclusions :
Preferred management practices for ocular trauma-related eye emergencies vary widely. Evidence-based consensus guidelines for the management of ophthalmic trauma are needed to ensure the highest quality of management for all ophthalmic trauma cases.
This is a 2021 ARVO Annual Meeting abstract.