The epidemiological characteristics and visual outcome of open globe eye injuries in Palestine: a retrospective chart review study

Abstract

BackgroundIn Palestine, there are frequent eye injuries but there is a scarcity of studies—data on prevalence, causes, risk factors, and the visual outcomes are inadequate. This study aimed to describe the magnitude, causes, burden, and visual outcomes of open globe eye injuries in Palestine, and to identify people at risk through distribution analysis of the injured patients by age, sex, and area of residency. MethodsA descriptive cross-sectional study was carried out, based on a review of all 413 patient files of cases of open globe eye injury undergoing surgical repair at St John Eye Hospital, Jerusalem, between January, 2000, and December, 2005. Ethics approval was obtained from the St John Eye hospital Ethical Committee. FindingsPatients were from all of the districts of Palestine. The mean age of the injured patients was 16·5 years (SD 14·1), with males comprising 82% of the study population. The eye injuries were analysed in three groups. Injuriesin preschool children (age 1–6 years) formed 28% of cases (116 of 413); the school-age group (age 7–18 years) was the largest category (39% of cases; 161 of 413); and the adult group (19 years and older) accounted for 33% of cases (136 of 413). For the school-age group, 15% (62 of 161) of eye injuries took place outdoors. Accidents accounted for 21% (35 of 161) of injuries in the group, whereas 12% (20 of 161) occurred owing to violence (for example, personal quarrels with injuries caused by fists, nails, sticks, and stones), and 12% (19 out of 161) were related to the second intifada (for example, due to rubber bullets, gun shots, explosions, and shrapnel from military action). For the adult group, 51% of eye injuries (69 of 136) occurred in the workplace, 21% (29 of 136) were caused by intifada, 14% (19 of 136) were caused by violence, 8% (11 of 136) occurred by accidents, and 6% were from unknown causes. Visual outcomes were measured after best correction (with surgery and with glasses); 21% (85 of 413) of all patients were left with a visual impairment, 21% (87 of 413) became blind, and 11% (47 of 413) lost an eye. InterpretationOpen globe eye injuries in Palestine have serious consequences, including visual impairment, blindness, and removal of the injured eye. However, this substantial impact on the patients' quality of life might be prevented by simple safety measures, legislative policies, and regulations. This study is cross-sectional in design and based on file abstraction; further studies should consider visual outcomes and preventive measures to minimise the risk of eye injuries. FundingNone.