Open Globe Injuries Decreased From 2006 to 2014, Study Finds

The incidence of open globe injuries decreased in the US from 2006 to 2014, according to a recent study published in JAMA Ophthalmology.

Researchers aimed to assess the incidence, common injury mechanisms, and economic burden of open globe injuries through a retrospective, cross-sectional study of US emergency department (ED) data. The study also reveals valuable information for targeting preventive measures at high risk individuals.

Ocular trauma is the leading cause of monocular vision loss in the United States, and one-third of serious eye injuries result in eventual blindness. Researchers note current available data on open globe injuries are insufficient.

“Globe rupture and perforation are prominent risk factors for blindness from ocular trauma,” authors said. “Despite the associated visual morbidity, greater than 90% of ocular trauma cases are preventable.”

Data were collected from the Nationwide Emergency Department Sample (NEDS) from January 2006 to December 2014. All ED visits of patients who received a primary diagnosis of open globe injury were included in the study.

A total of 124,989 ED visits for open globe injuries were evaluated. Researchers found that in 2006, the incidence was highest at 5.88 cases per 100,000 people. The rate subsequently decreased by 0.3% each month between 2006 and 2014 (incidence rate ratio, 0.99; 95% CI, 0.99-0.99; P < .001).

In addition, 37,060 individuals of low socioeconomic status suffered open globe injuries between 2006 and 2014. The most common cause of injury was being struck by or against an object or person.

The data showed that open globe injuries associated with falls increased 6.6% between 2006 and 2010 and between 2011 and 2015 (95% CI, 1.04-1.08; P < .001). Falls were the most common cause of open globe injuries for individuals older than 70.

Orbital fractures are associated with worse visual outcomes in patients with open globe injuries, as they likely indicate a more severe injury to the globe. Orbital fractures have previously been classified as “the most common primary diagnosis among hospitalized patients with ocular trauma,” researchers said. Results showed that “approximately 12% of patients older than 70 years had associated facial or orbital fracture, and these patients were 8.5 times more likely to be hospitalized.”

Researchers hope these findings will be used to target high risk individuals and implement preventive measures to reduce incidence rates. Populations at the highest risk for injury include young men with lower socioeconomic status, and individuals aged 70 or older as they are at an increased risk of falls.

Reference:

Mir TA, Canner JK, Zafar S, et al. Characteristics of open globe injuries in the United States from 2006 to 2014 [published online January 23, 2020]. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2019.5823.