Etiology and demographic factors associated with open-globe injuries in the United States: a multisite study

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Shruti Anant, BA
Alicia Casella, MD
Jason Greenfield, BA
Sarah Miller, MD
Kristine Wang
Bita Momenaei, MD
Karen Lee, MD
Hana A. Mansour, MD
Grant Justin, MD
Grayson W. Armstrong, MD, MPH
Taku Wakabayashi, MD
Yoshihiro Yonekawa, MD
Kara Cavuoto, MD, Bascom Palmer Eye Institute, University of Miami, Miami, Florida
Fasika Woreta, MD, MPH


We performed a retrospective, cross-sectional study to investigate the incidence, demographics, and injury mechanisms of open globes at major United States tertiary eye care centers.
The medical records of patients with open-globe injuries (OGIs) presenting to the Wilmer Eye Institute (n = 256 eyes), the Bascom Palmer Eye Institute (n = 510 eyes), and Wills Eye Hospital (n = 424 eyes) from January 2018 to December 2021 were reviewed. Factors associated with cause of injury, including age, sex, race, ethnicity, insurance, and zone of injury, were assessed using multivariable logistic regression.
Of 1,206 patients (mean age, 48.0 ± 22.9 years) presenting with OGIs, 891 (73.9%) were male, and 669 (61.4%) presented at an outside facility prior to transfer. Etiology included being struck by objects (41.1%), falls (20.7%), construction-related work injuries (15.3%), and assaults (11.4%). Patients 61 years of age and older were 17 times more likely than those 21-40 years of age to have an OGI from a fall, and female patients were twice as likely to have a fall-related injury compared with males. Uninsured patients were more likely to experience construction work OGIs than those with private insurance. Black patients had greater risk than White patients of experiencing assault and firearm injuries. Zone 3 injuries were more commonly associated with firearms (OR = 16.62; P < 0.001), assaults (OR = 5.94; P < 0.001), and motor vehicle accidents (OR = 5.54; P < 0.001) compared with direct object injury.
OGI etiology varies by demographic and clinical variables. Preventive strategies aimed at reducing the incidence of ocular trauma may benefit from targeting high-risk populations for falls, work-related accidents, and assaults.


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Anant S, Casella A, Greenfield J, Miller S, Wang K, Momenaei B, Lee K, Mansour HA, Justin G, Armstrong GW, Wakabayashi T, Yonekawa Y, Cavuoto K, Woreta F. Etiology and demographic factors associated with open-globe injuries in the United States: a multisite study. Digit J Ophthalmol. 2024;30. Accessed July 21, 2024.