Department of defense eye injuries from fiscal year 1988-1998.

BACKGROUND: The U.S. Army Safety Center, U.S. Navy Safety Center, and U.S. Air Force Safety Center collect data on occupational injuries that occur in each respective military service. METHODS: An 11-year retrospective study of ground eye injuries collected by the Army Safety Center, Navy Safety Center, and Air Force Safety Center, from Fiscal Year (FY) 1988 through FY 1998 was performed. Demographic data analyzed included rank, gender, age, and military/civilian status. Injury data analyzed included severity of injury, eye protection use, injury cost, work days lost due to injury, and days hospitalized due to injury. RESULTS: Statistics for Department of Defense (DoD) eye injuries indicate the average military individual who sustains an eye injury is a 20- to 24-year-old male, E3-E5. This individual is not wearing eye protection and will lose an average of 5.9 days from work at a cost averaging $6,295. The average civil service employee who sustains an eye injury is a WG6-10 who is a 30- to 39-year-old male. This individual is not wearing eye protection and will lose an average of 3.5 days from work at a cost averaging $1,598. Statistically significant differences in the numbers of eye injuries were observed between military occupational groups. In addition, incidence rates between military occupational groups were statistically significant. Category 1, Infantry, Gun Crews, and Seamanship Specialists, has the highest count of injuries and Category 7, Craftsworkers, has the highest incidence. CONCLUSIONS: Proactive vision conservation education at local levels needs to focus on these military occupational groups.     

Occupational open globe injuries

PURPOSE: Occupational ocular trauma is an important cause of acquired monocular blindness in a rapidly industrialising country like India. Knowledge of the epidemiology of occupational eye injuries is essential to formulate viable industrial safety measures. METHOD: We retrospectively reviewed all patients with occupational open globe injuries between 1994 and 1998. We documented the circumstances of the injuries, their clinical findings and the use of appropriate protective eyewear at the time of the injury. The visual acuity 6 months after the injury was the final outcome measure. RESULTS: In this study period we examined 43 patients with open globe injuries sustained at the work place. Thirty-four (79.1%) patients were young males. The iron and steel industry accounted for 19 (44.2%) cases while 8 (18.6%) patients each were from the agricultural, mining and other small scale industrial sectors. At the time of the injury, 33 (76.7%) were not wearing the recommended protective eyewear and 6 (13.9%) were under the influence of alcohol. The injuries were mild in 6 (13.9%), moderate in 18 (41.9%) and severe in 19 (44.2%) patients. At the end of 6 months, 2 (4.7%) patients had a visual acuity of 6/12 or better, 4 (9.3%) had a visual acuity of 6/18 to 6/60 and 29 (67.4.%) had a vision of <6/60. Eight (18.6%) patients were not available for follow up. CONCLUSIONS: Occupational open globe injuries are usually severe and are associated with a poor visual outcome. Mandatory use of protective eyewear and alcohol-free environment at the work place is likely to reduce the incidence of severe occupational open globe injuries.     

Epidemiology, visual outcome, and hospitalization costs of open globe injury in northern Sardinia, Italy

BACKGROUND: To investigate the epidemiology, visual outcome, and hospitalization costs of open globe injury in Northern Sardinia, Italy. METHODS: A population-based study involving all residents of Northern Sardinia. Hospital records were analyzed to obtain information on open globe injury. Age, gender, place of residence, occupation, cause of injury, circumstances, eye protection, visual outcome, and hospitalization costs were assessed. Statistical analysis was performed using an ordered probit estimate to calculate the predicted probability of visual outcome and a cross sectional linear regression model to evaluate some determinants of hospitalization costs. RESULTS: From 1993 to 2004, 176 residents (169 men, 7 women) were hospitalized for open globe injury. The overall annual incidence was 3.2 per 100,000. A bimodal age pattern was observed, with peaks at ages 20-24 and 50-59 years. The commonest occupation was "retired" (13.6%); 71% of injuries occurred during domestic or leisure activities. At the time of injury, 93.2% of patients were wearing no eye protection, 5.7% were wearing only ordinary spectacles, and 1.1% were wearing the correct protective equipment (safety goggles, shield). Final vision was < 3/60 in 27.3% of cases. Analyzing the predicted probability of blinding outcome, hospitalization costs were significantly influenced by greater age, retirement, residence in a rural area, and trauma occurrence during the weekend. CONCLUSIONS: Open globe injury in Northern Sardinia varied with age, gender, and residence, was associated with lack of eye protection, and often resulted in severe visual loss. People engaged in domestic or leisure activities, especially the retired, are at highest risk, suggesting the need for targeted messages. This could reduce the incidence of open globe injury and its associated costs on the community.     

Sports eyewear protective standards

Eye injuries sustained during sport comprise up to 20 per cent of all injuries to the eye serious enough for medical attention to be sought. The prevalence of eye injuries in sport is not easily assessed due to lack of authoritative participation rates, so most studies report total numbers in a time period. The evidence on the proportion of all ocular injuries that are from sport is reviewed. The relative frequencies in different sports are compared in a qualitative manner and the sports with greater numbers of ocular injuries are detailed. In common with occupational injuries to the eye, most sports eye injuries are considered preventable. The hierarchy of action for occupational risk is detailed and adapted to use in a sports scenario. All the available international, regional and national standards on sports eye protection are detailed and their provisions compared. The major function of the standards is to provide adequate protection against the hazard of the sport concerned. These are detailed and compared as a function of energy transfer. Eye protection must not introduce additional or secondary hazards (for instance, fracturing into sharp fragments on impact) and not introduce features that would deter the wearing of eye protection (for instance, restricting field of view to impede playing the sport). The provisions of the standards intended to limit secondary hazards are detailed and compared. The need for future work in standards writing and the activities of the International Standardization Organization in sports eye protection are detailed.     

A case-control study of eye injuries in the workplace in Hong Kong

OBJECTIVE: Eye injury in the workplace is common worldwide. This study proposed to explore both risk and preventive factors re eye injuries in Hong Kong. DESIGN: Case-control study. PARTICIPANTS: A total of 239 work-related eye injury patients, and 253 subjects without a history of any eye injury as controls. METHODS: Patients with all incident cases of work-related eye injuries attending the ophthalmology clinics of 3 major public hospitals in Hong Kong during the first 3 months of 2000 were invited to participate. Controls were selected from the general population and were frequency matched to patients based on gender. Patients were interviewed face-to-face by trained interviewers in the ophthalmology clinics, using a structured questionnaire. Telephone interviews were used for controls. MAIN OUTCOME MEASURES: Risk and protective factors associated with eye injuries. RESULTS: Among eye injury cases, 158 patients (66.1%) reported having incurred 1 episode of eye injury during employment, 49 (20.5%) having suffered 2 episodes, and 32 (13.4%) having experienced >/==" BORDER="0">3 eye injuries at work. Most of the patients (85.4%) did not wear any protective devices at the time of injury. Subjects who wore safety glasses regularly were less likely to have eye injuries (odds ratio [OR] = 0.29, 95% confidence interval [CI] = 0.14-0.62). Having a safety requirement for wearing safety glasses was negatively associated with eye injuries (OR = 0.31, 95% CI = 0.15-0.62). Multivariate analysis indicated that exposures to certain work hazards and working in the construction industry were positively associated with eye injuries. Subjects who worked longer in their current job, who reported having received job safety training before employment, or whose machines or equipment were maintained or repaired regularly by employers were at lower risk of experiencing eye injuries. CONCLUSIONS: Construction workers and those exposed to multiple hazards may get eye injuries at work. They should be provided with protective devices that are effective in preventing such exposures. Health education and safety training are important in preventing eye injuries. Maintenance and repair of machines and equipment may effectively reduce or eliminate the sources of exposures.     

Schutzbrille

Several activities in the occupational environment or in leisure time implicate an increased risk of eye injuries. Many injuries could be prevented by wearing adequate eye protection devices; however, the selection of appropriate eye protection devices requires considerations of different attributes in order to achieve a maximum of protection efficiency. This article provides an overview on the three basic types of eye protection device, introduces the classification regarding optical and protective properties and gives some additional advice on the selection of protective eyewear beyond the current standard regulations.     

374例眼外伤住院患者回顾性调查分析

目的通过对眼外伤患者各相关因素的分析,探讨眼外伤防治的方法和意义。方法对374例住院眼外伤患者的性别、年龄、职业、受伤地点、致伤原因、就诊时间、并发症及后果等因素进行统计分析。结果统计结果显示,男女之比为5.23:1。左右眼之比为1.15:1。多发年龄为1～40岁。职业依次为农民、学生、工人。受伤地点多见于工作场所及公共环境。机械性眼外伤占90.5%。农村患者多于城市(镇)患者,24小时内就诊率少于城市(镇)患者,差异具有显著性(P<0.01)。致盲率为44.7%。结论眼外伤是主要的致盲原因之一,从眼外伤的致伤人群及性质的分析中可知眼外伤注意预防的重要意义。     

Eye injuries caused by "Hornussen"--a traditional Swiss team game

BACKGROUND: "Hornussen" is a traditional Swiss team game played in rural areas of Switzerland. A puck made out of hard plastic called "Hornuss" or "Nouss" is hit with a lash like racket into the field. The opposing team has to capture the flying puck with shovel like shields. Eye injuries are rare, however, very severe. PATIENTS: We report on three patients who were seen and treated at the university eye clinic Berne in the last four years. RESULTS: All injuries were blunt contusions with involvement of the periorbital soft tissues by a hit with the "Hornuss". In two cases orbital fractures were observed and in one case there was a rupture of the globe in a pre-injured aphakic eye. Only in one case was there a direct hit to the eye by the "Hornuss", the other injuries were caused by indirect hit after the "Hornuss" bounced off the shovel like shields. No protection gear was used. One patient showed complete recovery, whereas in the other two cases significant impairment remained. CONCLUSIONS: Without adequate protection gear, injuries caused by "Hornussen" are generally severe. The injury pattern with periorbital involvement resembles eye injuries caused by baseballs. This is probably due to the similar size of the balls. The mandatory wearing of protection helmets issued by the federal "Hornusser" association for young players should be extended as a general requirement for all players.     

Ocular protection by contact lenses from mechanical trauma

Many lost-time industrial eye injuries are due to small highspeed particles striking the cornea. To investigate whether contact lenses would complicate such injuries, we exposed porcine eyes fitted in vitro with rigid, hydrogel, or no contact lens to iron filings suspended in a high-speed air jet. Postexposure evaluations of 11 control eyes and 23 contact lens-wearing eyes revealed more extensive and severe corneal damage in the control group. Of the 23 contact lens-wearing eyes, fewer and less severe corneal injuries were observed among those wearing rigid lenses. Contact lenses do not increase the risk of corneal injury due to small high-speed particles striking the eye; instead, they provide additional protection from mechanical injury.     

Epidemiologic characteristics and outcomes of open globe injury in Shanghai

AIM: To investigate the epidemiologic characteristics and outcomes of open globe injury in Shanghai. METHODS: A retrospective study was conducted for 148 unilateral open globe injury cases presenting to a tertiary referral hospital of Shanghai. Electronic medical records were reviewed and phone surveys were conducted to collect and analyze 1) background of patient; 2) setting of injury and clinical signs at presentation; 3) treatment procedure and outcome; 4) quality of life after injury. RESULTS: There were more male patients (77.03%) than females (22.97%), more temporary habitants (79.05%) than residents (20.95%). The subjects in this study presented a significantly lower constitutional status of education than that of the whole Shanghai population (P<0.001). Occupational injury was the first cause of injuries (39.86%), followed by home accident (20.27%), road accident (16.89%), violent behavior (16.89%) and outdoor injury (6.08%). The 143 subjects (96.62%) were not wearing spectacles at the time of injury. Of all patients, 77 subjects (52.03%) had the outcome of no vision (including enucleation). The classification and regression tree (CART) prognosis presents 59.58% sensitivity to predict visual survival correctly and 80.19% specificity to predict no vision correctly. The patients whose injured eye had no vision reported more reduction of life quality. CONCLUSION: We found that male subject, temporary habitants, low educational status and no eyewear are risk factors of open globe injury in Shanghai. Occupational injury is the leading cause. CART analysis presents a certain agreement to the actual visual outcome. The injury imposes negative impact on quality of life especially in no vision cases. The education of eye protection may help to avoid the injury.     

Serious fireworks-related eye injuries

OBJECTIVE. To analyze and compare epidemiological and clinical information on serious fireworks-related eye injuries from two affiliates of the United States Eye Injury Registry. METHOD. Retrospective review. RESULTS. In the Eye Injury Registry of Alabama (EIRA) database, 185 of the 4150 injuries (4.4%) were caused by fireworks. In the Hungarian Eye Injury Registry database, only two of the 1245 cases (0.1%, p=0.000001) were fireworks-related. In the EIRA, 79% of patients were males and 87% were under 31 years. A bystander was injured in 67% of the cases, being an average of 23 feet away; 39% of bystanders had a final vision =19/200. No injured person wore eye protection. Bottle rockets caused 80% of the 185 injuries. Overall, 20% of eyes had &lt;5/200 final visual acuity. Twenty-five percent of bottle rocket-injured eyes, compared to 64% of those injured by other devices, had =20/40 final vision (p=0.000004). CONCLUSIONS. The rate of fireworks-related serious eye injuries has not decreased in Alabama in the last 16 years; most patients are young males. Since bystanders are at a measurable risk even at a distance of 100 feet, wearing eye protection is recommended to both bystanders and operators. Bottle rockets cause most of the injuries and the more severe ones, and should be the prime target for prevention. The benefit of a strict and enforced legislative ban on private fireworks displays is demonstrated by the much lower incidence figure in Hungary. Such a ban should be considered in other countries where fireworks-related eye injuries are common.     

The eye and the seatbelt in Wessex.

The records of all 373 patients undergoing surgery for perforation of an eye at the 10 eye units in the Wessex Regional Health authority (except the Isle of Wight) during February 1980 to January 1984 were examined. There were 86 admissions as a result of road traffic accidents (RTAs), and 287 admissions arising from other accidents. The estimated annual incidence of perforating eye injuries as a result of RTAs has decreased by 73% following legislation for the compulsory wearing of seatbelts by drivers and front seat passengers. There is no evidence that this abrupt fall in the incidence of injury can be satisfactorily attributed to any other factor.     

Ocular injury caused by an air bag for a driver wearing eyeglasses.

BACKGROUND: Although air bags have been shown to reduce the number of fatalities and serious injuries caused by motor vehicle accidents, there have been many reports of air bag-related ocular injuries. We recently treated air bag-related corneal laceration in a patient wearing eyeglasses at the time of a motor accident. CASE: A 38-year-old Japanese man was driving a car at approximately 40 km per hour when he struck a stopped 2-ton truck. He was wearing a three-point lap-shoulder seat belt. At impact, the driver's-side air bag deployed and struck the man on the left side of his face. He was wearing eyeglasses with glass lenses, and the air bag broke the left lens of his eyeglasses, and glass fragments lacerated his cornea. OBSERVATIONS: External examination showed multiple superficial abrasions of the skin and ecchymosis of the left side of his face. Slit-lamp examination of his left eye showed corneal laceration and hyphema. The lens had opacities and was covered with fibrin membrane. Repair of the corneal laceration and phacoemulsification of the lens were performed. Six months later, his best corrected visual acuity was 20/20 in the left eye. CONCLUSIONS: As cars are increasingly equipped with air bags, reports of air bag-related eye injuries have increased. To our knowledge, this is the first reported case of corneal laceration caused by a shattered lens in an air bag-related injury. Ophthalmologists should caution patients about the danger of eye injuries in air bag-equipped cars, and thought should be given to improving the materials for eyeglasses.     

尼日利亚阿巴卡利基地区的眼外伤情况

目的:回顾尼日利亚阿巴卡利基地区眼外伤疾病的原因及视力结果。方法:阿巴卡利基联邦医疗中心事故急诊科或眼科收治的患者中,凡眼部损伤持续时间在18mo以上者(2000-06/2001-11),其治疗记录均得到回顾分析。结果:研究期间共108例眼外伤患者(男60,女48)。致伤活动包括:打斗/袭击30例(27.2%),玩耍/运动22例(20.4%,),农业活动18例(16.7%),家务劳动16例(14.8%)。致伤物体主要有棍棒、石头、拳头和公路交通事故相关物体。只有9例患者在伤后24h内前往医院接受治疗。治疗结果钝器伤患者视力最佳,刺伤患者视力最差。并发症主要包括白内障、角膜疤痕、青光眼。结论:阿巴卡利基地区的眼外伤疾病大多都可以预防,应加强公众的防治意识,使其了解相关方法,从而降低发病率。     

Ocular trauma resulting from paintball injury

Background  Paintball-related ocular injuries result in severe damage and loss of vision. Despite efforts to increase public awareness and improve safety features, the incidence of eye injuries has increased over time. We examined the characteristics and ocular effects of paintball injury at our tertiary referral center. Methods  Retrospective review of charts of patients with paintball injury between 1998–2005. Results  Fourteen patients were evaluated for paintball injury; 13 (93%) were male and one (7%) was female. Average age was 17 years (range from 9 to 30). Thirteen patients (95%) did not wear eye protection; one is unknown. Injuries occurred while playing paintball in three patients (21%); ten (71%) were injured in either accidental (four patients) or intentional (six patients) shootings not associated with play. Minimum follow-up was 6 weeks, except for one patient who was lost to follow-up. Seven patients (50%) had final visual acuity (VA) better than 20/200, six patients (43%) were 20/200 or worse, and information on one patient was not available. VA, except in one case, improved with treatment. Decreased VA in this case was due to proliferative vitreoretinopathy (PVR). Hyphema was noted in ten patients (71%), vitreous hemorrhage in eight (57%), retinal hemorrhage in six (43%), retinal tear or detachment in six (43%), commotio retinae in six (43%), iris injury in five (36%), keratopathy in four (29%), lens injury in two (14%), subluxation of lens in two (14%), secondary glaucoma in two (14%), open globe/intraocular foreign body (IOFB) in one (7%), choroidal rupture in one (7%), and proliferative vitreoretinopathy (PVR) in one (7%). Ten patients (71%) required intervention (surgery, laser retinopexy or cryotherapy). Conclusion  Paintball trauma results in significant ocular injury and loss of vision. Most injuries occur in unsupervised settings without proper eye protection. Ten patients (71%) were injured in accidental or intentional shootings. Lack of supervision and use of paintball materials as assault weapons make the risk for ocular injury more significant. Improved safety features of paintball equipment, along with continued education of proper eye protection, may reduce the incidence of severe ocular injuries. The authors have full control of the primary data, and will provide it to Graefe’s Archive for Clinical and Experimental Ophthalmology at their request. Neither author has any conflict of interest, financial or otherwise, to report. This work is supported by grants from Leir Foundation and Research to Prevent Blindness     

陕西省汉中地区眼外伤临床分析

目的:统计报告汉中地区眼外伤患者的流行病学状况及临床特点。方法:选择3a来资料完整的眼外伤住院患者172例进行回顾性分析。结果:汉中地区眼外伤以钝挫伤和穿通伤为主,分别占48.3%和37.2%。男性明显多于女性。年龄以31～40岁发病率最高(20.9%),50岁以前均呈现比较高的发病率。职业以农民最高,其次为学生和工人。治疗效果以单纯前房积血最好,爆炸伤和暴力伤治疗效果最差。脱盲率45.4%,最终致盲率34.3%。结论:眼外伤仍是致盲的最主要原因之一。加强青中年的劳动安全防护和教育,加强少年儿童的安全教育及鞭炮等爆炸物的管理对预防和减少眼外伤的发生是非常重要的。早期治疗,早期手术是降低致盲率的关键。     

Eye injuries in rural Victoria, Australia

Background:  Eye injury causes significant morbidity and is a leading cause of blindness worldwide. This study investigates the incidence, spectrum and patterns of eye injury presenting to a rural hospital in Victoria, Australia.
Methods:  A retrospective review of the medical records of all patients presenting with eye injury to the emergency department of Mildura Base Hospital, Victoria, Australia in year 2004 was conducted. As the emergency department of Mildura Base Hospital also acts as the outpatient department for this hospital, the series included all patients treated for eye injury at Mildura Base Hospital in year 2004, including admissions.
Results:  There were 435 patients present to Mildura Base Hospital emergency department for eye injury in 2004, which represented approximately 1% of the population of Mildura. The majority of eye injuries were superficial. Fifty-six (13%) patients required specialist attention. Most patients were male (83%) and were middle-aged. The most common locations where eye injuries took place were residential homes (47%) and workplaces (32%). The most common causes of eye injuries were trade tools and machinery (47%), followed by chemicals (12%) and branches/sticks/twigs (11%). Of particular concern for Mildura is that approximately one-quarter of the patients treated at Mildura Base Hospital for eye injury in 2004 had been treated at Mildura Base Hospital for a separate episode of eye injury in the past.
Conclusion:  Eye injuries represent a significant socioeconomic burden. This research contributes to the knowledge required for the design and implementation of effective preventative strategy.     

Epidemiology and risk factors for sports- and recreation-related eye injury: a multicenter prospective observational study

AIM: To identify the risk factors of epiphora in patients with anatomical patency after surgical repair of canalicular laceration. METHODS: This retrospective case series included 178 cases of canalicular laceration repair from 2005 to 2012. Demographic data collected from each patient included age, sex, type of injury, distance from the distal lacerated end of the canaliculus to the punctum, the severity score for the structural abnormity of the medial canthus, the duration of stent placement, and the timing of surgery. The risk factors for epiphora were evaluated using logistic regression models. RESULTS: Among the 178 cases, 45 (25.3%) with lacrimal patency after irrigation had symptomatic epiphora at the final follow-up. Patients’ sex, age, type of injury, duration of stent placement, timing of surgery, and concurrent trauma were not found to be signi?cantly associated with symptomatic epiphora after surgical repair of the lacerated canaliculus (P>0.05). A distance of more than 5 mm from the distal cut end to the punctum was closely and significantly associated with symptomatic epiphora after surgical repair of the lacerated canaliculus (P<0.01). Symptomatic epiphora was significantly more frequent in patients with higher severity scores for structural abnormities of the medial canthus (P<0.01). CONCLUSION: Our results indicate that the risk factors for postoperative symptomatic epiphora include a further distance between the distal cut end and the lacrimal punctum and a higher severity score for structural abnormities of the medial canthus. These findings could be used to prognosticate postoperative symptomatic epiphora.     

Epidemiology and sociodemographic aspects of ocular traumatic injuries in Iran

Although the incidence of ocular trauma has been clearly described in developed countries, few published data are available on the epidemiology and the effects of parameters that can influence the incidence and severity of ocular injuries in Iran. The present study tried to determine epidemiological aspects of ocular traumatic injuries and evaluate their effects on different types of ocular injury. The case series included 1950 consecutive patients with acute ophthalmic trauma presented to the emergency ward of Farabi Hospital in Tehran. Information was collected by interviewing patients and having them fill in a questionnaire. The final diagnosis was made by a medical resident. If there was a difficulty or doubt in diagnosis or classification, confirmation of diagnosis was made by senior faculty. Ocular injuries were classified into globe and non-globe injuries according to the site of injury. Mechanical globe injuries were classified according to Birmingham Eye Trauma Terminology (BETT) into closed and open injuries. The mean age of patients was 28.8 ± 12.8 years; 87.6% were male. The most common causes of injury were work-related (49.0%) and chance events (42.0%). The most frequent ocular injury was globe injury (95.6%), including mechanical (77.6% closed and 5.9% open), chemical (7.6%), photic (2.3%) and thermal (2.2%) injuries. Non-globe injury also occurred in 10.8% of patients; both globe and non-globe injuries occurred in 6.5% of patients. The hospitalization rate in all patients was 8.8%. Previous history of eye trauma was significantly more common in the group with isolated globe injuries (P < 0.001). History of eye trauma is a risk factor for globe injuries and female gender is a risk factor only for non-globe injuries. These two factors may predict future eye injury and increase its risk by 5.2 and 1.6 times, respectively.