Characterizing eye trauma in the United States: injury prevalence and risk

Abstract

Introduction
Injuries from different causes can lead to sight-threatening ocular trauma (OT). We characterized injury prevalence, risk, and trends to help in preventive planning.
Methods
Injuries were identified and retrospectively studied using International Classification of Diseases, 9th Rev, Clinical-Modification, from the National Trauma Data Bank 2007-2015. Statistical analysis was performed using SAS Release 3.8.
Results
Our search identified 732,826 OT from 22,716,943 injuries. Motor-vehicle-collisions (MVC) were the most prevalent cause (36.7%), followed by unarmed assault (15.3%), falls (7.9%), firearms (3.7%), and pedal cycling (2.2%). Sports, animal bites, explosions, and chemical injuries comprised 1% or less. Fall-related OT increased 1%/year while MVC-related decreased 1%/year from 4.9% and 44% in 2007 to 10.2% and 33.5% in 2015, respectively (P < 0.0001). The other causes did not change significantly. OT risk was highest in assault (12.0 in 100 cases), followed by animal-bites (6.8), explosions (6.2), pedal-cycling, sports, and chemicals (3.9), and was lowest in firearms, MVCs, and falls (2.5). OT risk did not change significantly from year to year (P > 0.10).
OT was most severe in firearms, MVC, and pedal-cycling injuries with average Injury-Severity- Score of 18.0, 17.19, and 13.31, respectively, resulting in the longest hospital stays of 10.17, 8.79, and 5.62 days, respectively. The average age of patients was lowest in animal-bites (7), sports (19), and explosions (28), while highest in falls (72), pedal-cycling (40) and assault (36). Senior (average age 72) White women had disproportionately higher odds of OT from falls, and children (average age 7) had higher odds of animal-bite OT.
Conclusions
Motor-vehicle-collisions, assault, and falls were leading causes of OT, with MVCs trending down and falls trending up for this period. Risk of OT was highest in assault, animal-bites, and explosions and did not change significantly over the years.