Characteristics and visual outcome of ocular trauma patients at Queen Elizabeth Central Hospital in Malawi

Abstract

To describe the epidemiology and visual outcome of patients with ocular trauma treated at Queen Elizabeth Central hospital in Malawi. A prospective, observational study was undertaken from September 2017 to December 2017. Data on socio-demographic features, aetiology of trauma, type of ocular injury pre-referral pathway and treatment of ocular trauma was collected as the exposure variables. The main outcome variable was best corrected visual acuity at 8 weeks following initial visit. A total of 102 patients (103 eyes) with ocular trauma were recruited with loss of follow up of 11 participants at 8 weeks following recruitment. The most affected age group were children under 11 years old (35.3%), followed by young adults of age between 21-30 years (22.5%). The male-to-female ratio for ocular injury was 2.8:1. Most participants had closed globe injuries (n = 72, 70.6%), with over half the population injured by blunt objects (n = 62, 60.8%). Furthermore, among the adult population, majority (n = 19 38%) were injured on the road during assaults (n = 24, 48%), while most paediatric injuries (n = 32, 61.5%) occurred at home during play. The incidence of monocular blindness was 25.3% at eight weeks after the first presentation. Factors that were associated with monocular blindness on multivariate analysis were living in rural areas and open globe injuries. Ocular trauma led to monocular blindness in a quarter of the study population. There is need for preventive education of ocular injuries at both family and community level.