Socioeconomic Status and Decreasing Incidence of Ocular Injuries in Bosnia and Herzegovina

Abstract

ABSTRACT Purpose: To examine the epidemiologic and clinical characteristics of ocular injuries and their association with socioeconomic status (SES). Material and Methods: All cases of ocular injuries hospitalized in Department of Ophthalmology of University Clinical Center Tuzla, Bosnia and Herzegovina, from January 2009 to December 2012 and January 2017 and December 2019 were prospectively followed. The injuries were classified according to Ocular Trauma Classification System (OTCS) and Birmingham Eye Trauma Terminology (BETT). Results: This study included a total of 420 eyes from 396 patients. There were 162 (38.57%; 95%CI: 32.86–44.99) open globe injuries (OGI) and 258 (61.43%; 95%CI: 54.16–69.4) closed globe injuries (CGI). The decrease in incidence of ocular trauma requiring hospitalization was noted from 16.7 per 100 000 (95%CI: 13.11–20.97) in 2009 to 9.25 per 100 000 (95%CI: 6.64–12.55) in 2019 (p=0.006). Most injuries occurred in males 341 (81.19%; 95%CI: 72.8–90.28), active working patients 258 (61.43%, 95%CI:54.16–69.4), and patients with rural residence 285 (67.86%; 95%CI: 60.21–76.21). Almost all ocular injuries 418 (99.52%; 95%CI: 90.21–109.54) occurred in patients with middle and lower SES categories, and home was the most prevalent place of injury in 258 (61.43%, 95%CI: 54.16–69.4) patients. The total of 289 (70.49%; 95%CI: 62.59–79.1) patients had good final best corrected visual acuity (BCVA). Poor final BCVA was associated with lower ocular trauma score (OTS) (p=0.000), poor initial BCVA (p=0.000), penetrating injuries of cornea (p=0.004) and sclera (p=0.001), Zone III injuries (p=0.000), intraocular foreign body presence (p=0.000), cataract (p=0.002), retinal detachment (p=0.001), endophthalmitis (p=0.000) and vitreous hemorrhage (p=0.010). Conclusion: This study provides a detailed insight into epidemiology and socio-economic characteristics of patients hospitalized for ocular injuries.