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PurposeMethodsResultsConclusionTo explore patient and surgeon characteristics for open globe injury repairs (OGRs) and rates of subsequent operations.Using a retrospective cohort design, eyes of patients ≥18 years who underwent OGR among 100% Medicare Fee-For-Service dataset from 2011 to 2020 were included. Current Procedural Terminology (CPT®) codes were used to identify OGR. Patient characteristics were reported, and surgeon characteristics were stratified by sex and compared using Chi-square and Student’s t-test. Overall rate of subsequent operations was reported, and trends of subsequent operations over time were assessed using Cochrane-Armitage trend test.A total of 16,576 patients with a mean age of 73.89 years (±12.89) underwent OGR. Most patients were White (79.68%, n = 13,207) and 49.44% (n = 8196) were female. More patients resided in a rural area (18.71%; n = 3102) relative to surgeon location (4.51%, n = 748; p < 0.001). A total of 5,898 surgeons performed these OGRs with 77.33% (n = 4,561) male and 22.67% (n = 1,337) female surgeons. Male surgeons performed most of the OGRs (76.35%, n = 12,655; p < 0.001). On average, a surgeon performed a single OGR annually (Mean: 1.08 ± 1.04; Range: 0.11–40). Among all OGRs, 51% (8,452/16,576) had ≥1 subsequent operations in median 29 days (IQR: 10–86), which increased during the last decade from 47% to 51% (p = 0.008).Geographic and workforce disparities in ocular trauma warrant future investigation. Further studies can also assess the reasons for increase in the incidence of subsequent procedures after OGR over time. [ABSTRACT FROM AUTHOR]

To evaluate the occurrence and outcome of open globe injury during state-mandated COVID-19 stay-at-home orders compared to historical averages at a tertiary medical center in Portland, Oregon. Open globe injury between January 1, 2015 and December 31, 2020 was identified using relevant procedure codes. The number of injuries, mechanism of trauma, and short-term outcomes of globes repaired during the study period of March 23, 2020 to July 6, 2020 when stay-at-home orders were in effect were compared to a cohort from the same 15-week time frame in 2015–2019. We also evaluated injuries occurring throughout 2020 as compared to the prior 5 years. 263 consecutive open globe injuries were identified between January 2015 and December 2020. While Oregon's stay-at-home orders were in effect, we observed a significant increase in the number of open globe injuries treated compared to the prior 5 years (p =.004). Twenty-four cases identified during the study period represent a 2-fold increase over the 2015–2019 average of 11.8 globe repairs during the same 15-week time period. Visual acuity < 20/200 at 6 months (p =.008) and secondary enucleation (p <.001) were more frequent during stay-at-home orders, and severity of injury as calculated by the Ocular Trauma Scores (OTS) was higher. Time-to-repair was similar between the two cohorts. At our center, there was an increased number and severity of open globe injury during the period of mandatory COVID-19 stay-at-home orders. Visual acuity outcomes and risk for secondary enucleation were poorer compared to the reference cohort. Abbreviations: Ocular Trauma Score (OTS), Open globe injury (OGI), Emergency department (ED), Oregon Health and Science University (OHSU) [ABSTRACT FROM AUTHOR]

To identify risk-factors for developing endophthalmitis following open globe injury (OGI) in children. Retrospective, single-center, case-control study of children aged <18 years who sustained OGI. Our cohort of 93 eyes consisted of 30 cases (Group A- endophthalmitis) and 63 controls (Group B- no endophthalmitis). Twenty-four eyes (80%) diagnosed with endophthalmitis presented after 24 hours of injury. The presence of central corneal zone-1 injuries (Odd ratio [OR]: 6.64, p= 0.001) and vitreous in wound (OR: 3.53) were associated with the risk of developing endophthalmitis. (p= < 0.05) Additionally the presence of iris prolapse (OR: 4.76) and posterior capsular rupture (PCR) (OR: 5.80) increased the risk of developing endophthalmitis.(p <0.05). Streptococci was isolated in 15 eyes, Pseudomonas in 3 eyes, and Candida in 1 eye. The visual outcomes at three months were significantly worse in Group A (LogMAR 1.77±1.06) compared to Group B (LogMAR 0.65±0.68)(p<0.05). Central corneal involvement, vitreous/ iris incarceration and PCR were important risk factors for development of PTE in children [ABSTRACT FROM AUTHOR]

This article discusses a case of sympathetic ophthalmia, a rare condition characterized by inflammation in both eyes following an injury to one eye. The case involves a 32-year-old male who experienced a perforating open globe injury to his right eye due to a firework accident. Three weeks later, he developed bilateral granulomatous uveitis. The article provides a detailed description of the patient's condition, including gross and microscopic examination findings. The authors present this case as an example of sympathetic ophthalmia, highlighting the rarity of the diagnosis. [Extracted from the article]

To study the epidemiology of inpatient open globe injuries (OGI) in the United States (US). This was a retrospective cohort study of patients with a primary diagnosis of OGI in the National Inpatient Sample (NIS) from 2009 to 2015. Sociodemographic characteristics, including age, gender, race, ethnicity, insurance, and income were stratified for comparison. Annual prevalence rates were calculated using 2010 US Census data. Statistical analysis included Chi-square tests, ANCOVA, and Tukey tests. A total of 6,821 US inpatient hospital discharge records met inclusion/exclusion criteria. The estimated national prevalence of OGI during the 5-year period from 2009 to 2015 was 34,061 (95% confidence interval [CI] 31,445–36,677). The overall annual prevalence rate was 1.58 per 100,000 per year (CI 1.56–1.59). Overall, average annual prevalence rates were highest among patients 85 years or older (7.72, CI 6.95–8.49), on Medicare (3.92, CI 3.84–4.00), males (2.28, CI 2.25–2.30), African Americans (2.38, CI 2.32–2.44), and Native Americans (1.80, CI 1.62–2.00). OGI rates were lowest among Whites (1.21, CI 1.19–1.22), females (0.89, CI 0.87–0.91), those with private insurance (0.84, CI 0.82–0.86), and Asians (0.69, CI 0.64–0.74). Being in the lowest income quartile was a risk factor for OGI (p <.05). Inpatient OGIs disproportionately affected those over 85, young males, elderly females, patients of African-American descent, on Medicare, and in the lowest income quartile. Additionally, children and young children had lower rates of OGI compared to adolescents. Further studies should delineate causes for socioeconomic differences in OGI rates to guide future public health measures. [ABSTRACT FROM AUTHOR]

Orbital trauma, particularly with open globe injury, can have a wide range of visual outcomes, which can be difficult to predict at presentation. Clinical features on presentation may provide insight into visual prognosis. We hypothesized that patients with open globe injuries and concomitant orbital fractures have poorer visual outcomes than patients without orbital fractures. We reviewed the charts of 77 patients with isolated open globe injuries (OG) and 76 patients with open globe injuries and concomitant orbital fractures (OGOF). Multivariate regression analysis was performed to assess the relative influence of individual presenting historical and clinical features on visual outcome. OGOF patients were more likely to have sustained blunt trauma than a sharp, penetrating injury compared to OG patients. Ocular wound locations were more posterior and likely to involve multiple zones in OGOF compared to OG patients. Among OGOF patients, orbital floor fractures were the most common and roof fractures were the least common, but the latter was associated with presenting NLP vision and multiple zone involvement. The presence of an orbital fracture independently increased the odds of subsequent evisceration/enucleation (OR: 4.6, 95% CI 1.3–20.1, p =.0246) and NLP vision (OR: 6.81, 95% CI 2.42–21.85, p =.0005) when controlling for zone, mechanism of injury, uveal prolapse and demographic variables. The presence of an orbital fracture independently confers a worse visual and ocular prognosis in patients with open globe injuries. Patients with open globe injuries in this category should be appropriately counseled. [ABSTRACT FROM AUTHOR]

To describe a case of inflammatory neovascularization of the lens after open globe injury.Case report.A 57-year-old man presented with severe inflammation, posterior synechiae with traumatic cataract, and thick neovascularization of the intralenticular and anterior lens capsule after open globe injury in the left eye. We administered an intravitreal bevacizumab injection and performed cataract surgery with synechiolysis 1 month later.Inflammation after open globe injury may present as intralenticular neovascularization. Before cataract surgery for traumatic cataract with intralenticular neovascularization, the use of intravitreal bevacizumab injection was ineffective. [ABSTRACT FROM AUTHOR]

Purpose: Firework devices cause high numbers of eye trauma cases each year worldwide. These can range from mild conjunctival irritation to devastating loss of all vision or the organ itself. A systematic 10-year retrospective monocentric case analysis was the main aim of this study. Materials and Methods: All firework-associated eye trauma patients treated in our clinic from 2007 to 2017 were grouped for trauma severity and analyzed for influencing factors like age, gender, laterality, final visual acuity, and ocular trauma score (OTS). Results: Between 2007 and 2017, 165 eyes of 149 patients were treated due to firework-associated eye trauma at our clinic. The mean patient age was 28.5 ± 14.4, 116 patients (78%) were male, 113 (75.8%) were bystanders, 94 right and 71 left eyes were treated, and final visual acuity was 0.26 ± 0.54 logMAR. The causative device were bangers in 98 cases (59%), rockets in 54 cases (33%), and sparklers in 13 cases (8%). Patients were significantly older (p = 0.026), final visual acuity was significantly lower (p < 0.01), and OTS was significantly higher (p < 0.01) in patients suffering from major eye trauma compared to minor trauma cases. Conclusions: Patients suffering from firework-associated eye trauma are mostly young, male, and bystanders. However, severe trauma is more frequent in higher age groups, leading to serious consequences. In Germany, more educational efforts and prophylaxis concerning eye trauma caused by firework devices are desirable. [ABSTRACT FROM AUTHOR]

Management of ocular trauma is both challenging and controversial. Using current available evidence in literature and author experience this review aims to highlight critical issues in management of ocular and orbital trauma. This review provides a working framework from initial presentation, investigations, management principles, complications and prognosis to outcome and controversies involved in management. The review will focus on the concept of atraumatic repair of traumatized globe and will also give guidelines about strategic planning in ocular trauma management. Clinicians are occasionally faced with dilemmas and challenges in management of severely traumatized eyes with limited or no visual potential in view of life-time risk of sympathetic ophthalmia and the authors aim to address the controversy surrounding it. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]