A 10-year review of assault-related open-globe injuries at an urban hospital

Background

To describe the demographics and outcomes of assault-related open-globe injuries (OGI) at University Hospital (UH), Newark, New Jersey over a ten-year period.

Methods

The medical records of all subjects presenting to a single university referral center with an OGI were retrospectively analyzed to identify prognostic factors for enucleation and final visual acuity (VA) of no light perception (NLP).

Results

One hundred and forty-eight eyes of 147 patients presented to UH with assault-related OGI. Eighty-two percent of patients were male, and the mean age was 35.9 years. The anatomic site of the wound was zone 3 in the majority (54.1 %) of eyes. Most common type of injury noted was rupture (57.4 %), followed by penetrating injury (35.1 %). Mean initial presenting and final VA in LogMAR were 2.38?±?0.12 and 2.18?±?0.16 respectively. Initial Snellen VA was no light perception (NLP) in 57 eyes (38.5 %); four eyes had an initial VA of ≥20/40 (2.7 %). Final VA was NLP in 68 eyes (45.9 %) of which 46 were enucleated (31.1 %); 18 eyes (12.2 %) had a final VA of ≥20/40. Fifty eyes (33.8 %) underwent pars plana vitrectomy (PPV). Significant risk factors of final VA of NLP or enucleation included initial VA of NLP, perforating or rupture type of OGI, and zone 3 injury. Eyes that sustained penetrating injuries were less likely to have final VA of NLP or require enucleation.

Conclusions

Assault-related OGIs carry an extremely poor visual prognosis and a high rate of enucleations. Only eighteen eyes (12.2 %) recovered VA ≥20/40. We found initial VA of NLP and zone 3 injury to be significant predictors of final VA of NLP or undergoing enucleation. Penetrating injuries were less likely to have a final VA of NLP or an enucleation.