Epidemiology of motor vehicle accident–associated ocular trauma

Abstract

Introduction
The objective is to investigate trends in cases of motor vehicle accident-associated (MVA- associated) ocular trauma in which the patient was the driver of the motor vehicle.
Methods
The study utilizes data from the 2007-2014 National Trauma Databank (NTDB), a national trauma registry. Status as the driver of the motor vehicle was identified using E-Codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Trauma diagnoses were identified using D-Codes from the ICD-9-CM. This study included all patients over the age of 14 (youngest age in the US at which one can obtain a learner’s permit). 
Results
We identified 49,660 cases of ocular trauma secondary to an MVA. Men comprised 68.6% (34,057) of cases. New drivers (ages 14-17) accounted for 4.1% (2,024) of cases. Majority of injuries (55.2%) occurred in the 18-40-year age group. Orbital floor fractures (OFFs) were the most commonly observed ocular injury, occurring in 17,647 (35.5%) cases. There were 2,787 cases of open globe injury (OGI). The proportion of cases with an OFF was highest in the 41-60- year age group (37.4% of cases) and lowest in the 81+ age group (26.5% of cases). The highest proportion of cases with an OGI was seen in the 81+ age group (7.1% of cases). OGIs were seen in 3.0% of cases with OFFs vs. 7.1% in those without. The mortality rate was 4.3%; the rate was highest in the 81+ age group (13.5%) and lowest in the 18-40 age group (3.3%).
Conclusion
Men and young adults comprised the majority of cases of MVA-associated ocular trauma. OFFs were seen in approximately one-third of cases of ocular trauma. OGIs were less commonly observed when a concurrent OFF was observed. Though the overall mortality was 4.3%, there was significant variation by age group.