Open Globe Eye Injury Research Articles

Contribution of the Association of CT scan and Ocular Trauma Score in Open Globe Ocular Injuries: Mohammed VI University Hospital Experience

Objective: The aim of this study was to assess the association between oculo-orbital CT scan results and Ocular Trauma Score (OTS) in open globe injuries. Methods: In 65 eyes with open globe injuries undergoing oculo-orbital CT, they were classified into 5 major types: intraocular foreign body/air, scleral irregularity with decreased globe volume, lens dislocation, abnormal vitreous density, choroid layer thickening, and choroidal detachment. The association between different types and the number of CT findings with OTS stages was evaluated. Results: The average age of patients was 37 ± 15.8 years. The most common CT findings were the presence of intraocular foreign bodies (63.1%), severe scleral irregularity (18.5%), and abnormal vitreous density (23.1%). The most frequent OTS stages were III (47.7%) and II (21.5%). Univariate analysis showed that severe scleral irregularity (OR = 0.015; p = 0.001), abnormal vitreous density (OR = 0.095; p < 0.004), choroidal layer thickening (OR = 0.211; p = 0.006), and foreign body (OR = 9.50; p = 0.004) were associated with more advanced OTS stages (I and II). The discovery of more anomalies on CT was associated with severe ocular injuries, namely OTS I (p < 0.001) with corresponding low final visual acuity. Conclusion: CT results can aid in predicting OTS stage and visual prognosis in open globe eye injuries.

FACTORS CONTRIBUTING TO OPEN GLOBE INJURIES AMONG PATIENTS ATTENDING EYE CARE SERVICES AT MBALE REGIONAL REFERRAL HOSPITAL FROM AUGUST 2022 TO MARCH 2023. A CROSS-SECTIONAL STUDY.

Background Cases of open globe injuries are on the increase in various countries mainly as a result of occupation, accidents, and sharp instruments in children. Thus, this study determined the factors contributing to open globe eye injuries among patients attending the eye care services at Mbale Regional Referral Hospital. Methodology Used a cross-sectional design employing quantitative methods of data collection. 100 respondents who participated in the study were selected, where only patients with open globe injuries as well as caretakers were chosen among patients attending eye care services at MRRH. Results Regarding socio-demographic factors, the majority of the respondents (43%) who drank alcohol, (79%) agreed that open globe injuries are more common in children than adults, (52%) mentioned the cornea as the most affected part of the eye. According to individual-related factors, (70%) of the respondents agreed that social-economic status is associated with open globe injuries, (58%) said playing with sharp instruments/objects. Regarding environmental-related factors contributing to open globe injuries, the majority (47%) got injuries at home, (35%) said industry/construction jobs have high risks of open globe injuries. Conclusions Open globe injuries are more common at young age than the adults. Sharp objects like sticks are the most common cause of global injuries among individuals. The socioeconomic status of an individual is associated with global injuries Recommendations Health workers especially ophthalmologists, and ophthalmic clinical officers should sensitize the community and the whole public on risk factors, causes, and how to prevent global injuries. Parents should strictly monitor their children to prevent open globe injuries. Finally, industrial managers, construction engineers, and army commanding officers should procure protective gear and ensure that their workers take precautions like wearing protective gear while at work

Presenting clinical characteristics of open globe injuries in ocular trauma: baseline analysis of cases in the ASCOT national clinical trial

Background/ObjectivesThe Adjunctive Steroid Combination in Ocular Trauma (ASCOT) trial is a unique pragmatic, multi-centre, patient and assessor masked, randomised controlled trial. We evaluate the clinical characteristics and pathology of this large trial cohort of patients with open globe injuries undergoing vitreoretinal surgery, including the associations between patient characteristics and their baseline vision.Subjects/MethodsWe (i) summarise demographics, injury history and ocular history of the 280 participants recruited into the ASCOT trial using descriptive statistics; (ii) analyse the national and seasonal variation across England and Scotland in these participant characteristics; and (iii) explore the associations between participant demographic, trauma history, ocular history and presenting baseline visual acuity (measured using the Early Treatment Diabetic Retinopathy Study, ETDRS) using multivariable regression analyses.ResultsThe majority of participants with open globe penetrating injuries were of white ethnicity (233, 84%), male (246, 88%), with a median age of 43 years (IQR 30–55 years). There was considerable variability in presenting visual acuity with 75% unable to read any letters on the ETDRS chart, whilst the median ETDRS letter score was 58 (IQR 24–80) for those who could read ≥1 letter. The most common causes of injury were workplace related (31%) or interpersonal violence (24%). Previous eye surgery, visual axis corneal scar, lens status, hyphaemia and vitreous haemorrhaging were found to be associated with presenting vision as measured by the ETDRS chart.ConclusionThe ASCOT trial provides valuable insights into the spectrum of pathology of patients with open globe eye injuries undergoing vitreoretinal surgery. The identified causes of injury and clinical presentation of the cases will help in training and resource planning to deal with these often challenging surgical cases.Trial registrationEudraCT No. 014-002193-37. HTA Project 12/35/64.

Epidemiological Characteristics and Outcome of Open Globe Injuries in Tabuk City, Kingdom of Saudi Arabia: Retrospective Cohort Study.

IntroductionThe objective of this study was to assess the epidemiological characteristics, clinical features and visual outcomes of open globe eye injury (OGI) in Tabuk, Saudi Arabia.MethodsA retrospective chart review of OGI patients who had undergone operative repair of their injuries in Tabuk, Saudi Arabia. The collected data included patients’ demographics, duration between trauma and presentation and the mechanism of trauma, wound location, extent of injury, presence of intraocular foreign body, and initial and final visual acuity data.ResultsSixty-three eyes of 63 patients who were admitted for traumatic globe rupture were included; 84.1% were males and 39.7% were of pediatric age. Delay in seeking medical care for > 24 h was recorded in 4.8% of patients. The most common (42.9%) mechanism was blunt trauma followed by sharp trauma (38.1%) and projectile trauma (9.5%); 55.6% had the injury in zone 1. Intraocular foreign body was reported in 9.5% of patients. Intraocular foreign bodies were significantly more common in adults (p = 0.018) compared to children. Poor visual acuity was noted in 77.8% of patients upon presentation and 60.3% on last visit.ConclusionThe incidence of OGI was more common in males. The most common cause of OGI was blunt injury, and half of the injuries were in zone 1. Visual outcomes are guarded for most patients with OGIs.

Mechanisms and Prevention of Open Globe Eye Injuries

Purpose: Open globe injuries are a frequent cause of unilateral vision loss. The purpose of our study was to determine the epidemiological data of open globe injuries during a 15-year period in Central East Slovenia.
 Methods: A retrospective analysis of 219 patients (219 eyes) with open globe injuries admitted to the Department of Ophthalmology in the University Clinical Centre Maribor, Slovenia, from January 1999 to January 2014 was performed. We analyzed the following parameters: sex, age, month of injury, place of injury, type of injury, and mechanism of injury, grouped according to sex.
 Results: The majority of patients were male (186 patients, 85%). The mean age of male patients was 38 years with almost 45% of injuries occurring in the age interval between 30 and 50 years. Most injuries occurred during the colder part of the year from October to January. The most common place of injuries was the home (126 eyes, 66.5%). The most common open globe injuries were penetrating injuries (126 eyes, 57.6%) and rupture of the globe (49 eyes, 22.4%). Males most frequently experienced open globe injuries as a result of sharp objects (86 eyes, 46%), while in females, the most common causes of injuries were falls (10 eyes, 31%) and blunt objects (10 eyes, 31%).
 Conclusions: The vast majority of eye injuries are preventable. Studying the causes of injuries for a determined region is important to provide for preventable measures, like the use of eye protection, and to provide health education, to prevent severe vision loss or blindness.

Visual outcomes associated with delay from trauma to surgery for open globe eye injury in Palestine: a retrospective chart review study

BackgroundOpen globe eye injuries have poor visual outcomes. In Palestine, no studies have completely described the impact of time delays to surgery on visual outcomes. This study examines the causal factors for open globe eye injuries, time to presentation, and the effects of delays to surgery on visual outcomes. MethodsA retrospective review was carried out of 413 patients with monocular open globe eye injuries attending St John Eye Hospital, Jerusalem, occupied Palestine territory, from Jan 1, 2000, to Dec 31, 2005. Injury cause, time to presentation, visual acuity on arrival, and the final corrected visual outcomes were assessed. FindingsOpen globe eye injuries were caused by traumatic injury during the Intifada in 2002 (13%) and military actions throughout the study period (14%), but most injuries (38%) occurred in workplace or were related to domestic eye injuries (20%). The median time from open globe eye injury to arrival at hospital was 4 hours (IQR 11–3); 290 (70%) of 413 patients arrived within 8 h of injury. Visual acuity on arrival was normal only in five eyes (1·2%), functionally accepted vision in 42 eyes (10%), visually impaired in 77 eyes (18.6%), blindness in 229 (55%), and difficult to measure in 60 (15%). Surgical repair was performed in 366 eyes (89%) and 47 (11%) eyes were removed. After surgery, visual status was classified as visual acuity impaired in 85 (20·6%) of 336 repaired eyes, blindness in 87 (21%), normal vision restored in 58 eyes (14%), functionally acceptable vision restored in 116 eyes (28%), difficult to measure in 20 (4·8%). Among the 290 patients who presented within 8 h of injury, the final visual outcomes were impaired visual acuity in 72 (25%), blindness in 71 (24%), eye removed in 38 (13%), and visual acuity difficult to measure due to very young age or devastating injury remaining after surgery in 14 (4.8%) and vision was restored in 95 (33%). InterpretationDespite the devastating nature of open globe eye injury, minimum time from trauma to surgical intervention could save the injured eyes. Further studies should investigate whether delay in surgery affects outcomes in relation to the severity of injuries, as this study is cross-sectional and longitudinal epidemiological studies might yield better interpretations. FundingNone.

Controlled release of triamcinolone from an episcleral micro film delivery system for open-globe eye injuries and proliferative vitreoretinopathy

Open globe trauma is the major cause for single eye blindness that stem from subsequent proliferative vitreoretinopathy (PVR). Though biomaterials and tissue engineering have significantly advanced drug delivery and management of human diseases, currently there is no effective drug formulation or device to pharmacologically mitigate PVR formation after open-globe eye trauma. This highlighted the challenge we are facing to bring the technology from bench to bedside. The current study reported an engineered episcleral drug film using biodegradable material, Poly(L-lactide)-co-poly(ɛ-caprolactone), and triamcinolone acetonide (TA) as a model drug. The film can be conveniently sized into any shape to fit the configuration of the eye globe trauma and easily installed onto the ruptured sclera during primary trauma repair surgery. The film allows therapeutic TA to slow release for at least 6 months without toxicity and demonstrated a significant benefit to reduce the odds of developing severe PVR by 5.7 times when compared with a no-drug film control on a rabbit trauma PVR model. Our results suggested this micro episcleral drug film as promising drug delivery carrier for the targeted treatment of various unwanted retinal proliferation diseases.

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

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.

New approaches to managing open globe eye injuries with a thermoresponsive sealant

Traumatic eye injury is the leading cause of unilateral blindness worldwide, especially in developing countries. Open globe injuries, which have the tendency to lead to severe visual impairment, account for about 10% of these injuries (1). The risk for open globe injury was highest in young adults (2) who were actively engaged in economic activities; therefore, open globe injuries not only affect the quality of life and economic condition of patients, but also cause a great deal of cost for society as a whole (3).

Open globe eye injury characteristics and prognostic factors in Jazan, Saudi Arabia.

ObjectivesTo evaluate characteristics and prognostic factors of open globe injuries (OGI) presented to King Fahad Specialist Hospital in the Jazan region, Saudi Arabia.MethodsThis study is a retrospective review of medical records of OGI patients who underwent operative repair of their injuries in King Fahad Central Hospital, Jazan, Saudi Arabia between January 2011 and December 2013. Demographic information, eye injury, preoperative, and postoperative visual acuity were collected. The initial and final visual acuity outcomes were compared to identify subjects who witnessed any improvement in their visual acuity. Logistic regression was used to assess characteristics associated with improvements in the visual acuity.ResultsNumber of included cases was 120. Most frequently reported causes of injury were blunt trauma (20%) and shattered glass (18.3%). Approximately half of the cases were reported to have iris injuries or hyphema. Most cases suffered penetration (37.5%) of the eye globe. Only zone I injury was significantly associated with better visual acuity outcomes (odds ratio [OR]: 2.447, p=0.036). Among the variables that were associated with poorer prognostic outcomes, only aphakia (OR: 0.180), retinal damage (OR: 0.062), vitreous hemorrhage (OR: 0.266), and zone III injuries (OR: 0.092) were statistically significant (p<0.05).ConclusionZone I injury appears to have a better prognostic effect on visual acuity where injuries related to Zone III were associated with worse prognostic outcomes.

Visual outcome after emergency surgery for open globe eye injury in Japan.

BackgroundMost patients with open globe eye injury are brought to hospital as emergency patients and usually require admission for emergency surgery. We analyzed the visual outcome in patients with open globe eye injury at our hospital over a 4-year period.Patients and methodsThis study reviewed 40 eyes of 40 patients with open globe eye injury who were presented to Juntendo University Shizuoka Hospital and required emergency surgery during the 4 years from January 2010 to December 2014. Retrospective evaluation of the visual outcome was performed using data from the medical records, including assessment of the influence of sex, side of the eye injury, cause of injury, and site/severity of injury.ResultsThe mean age (SD) at the time of the injury was 58.9 years (±25.1 years). There were 28 males (70.0%) and 12 females (30.0%). Statistically significant improvement in visual acuity after treatment was noted in the males (P=0.0015, Wilcoxon test), but not in the females. Twenty-five patients had injury to the right eye (62.5%) and 15 had injury to the left eye (37.5%). A significant improvement in visual acuity was achieved after treatment of injury to the right eye (P=0.021), but not the left eye (P=0.109). The most frequent cause of injury was an accident (15 eyes; 37.5%). The second most frequent cause was work-related injury (14 eyes; 35.0%), which only occurred in males, and the third cause was accident due to negligence (eleven eyes; 27.5%). Two patients developed sympathetic ophthalmia and one patient developed postoperative endophthalmitis.ConclusionThe majority of patients with open globe eye injury were male workers in Japan. The visual outcome of work-related injury was better than that of injury due to other causes. The visual outcome was also better if the right eye was injured compared with the left eye. Patients with injuries due to negligence were older than the other groups, and this finding might be characteristic of an aging society.

Suriye İç Savaşı?ndaki Açık Göz Küresi Yaralanmaları

Objective: To analyze the incidence and severity of open globe injuries among the Syrian anti-regime forces and Syrian civilians in Syrian Civil War. Material and Methods: Open globe injuries were retrospectively analyzed on 39 patients (43 eyes) hospitalized at Kilis State Hospital in Turkey, Department of Ophthalmology, between August 2012 and May 2013. Informed patient consents were obtained preoperatively. We reported the causes and localization of ocular injury, presence of the intraocular foreign body and the microsurgical treatment applied. Results: A total of 43 eyes of 39 patients were included in the study. The average age was 24.8 years, ranging from 4 to 50. Ten patients (25.6%) were <18 years old, and 29 patients (74.4%) were ≥ 18 years old. Four patients (10.2%) had bilateral eye injuries. While fragments of explosive devices (rockets, grenades) were responsible for 26 eye injuries (60.5%), gunshots were the cause of the 17 eye injuries (39.5%). Primary evisceration was performed on 4 eyes (9.3%), because of the destruction of the eye. Conclusion: Extraordinary presentations and subversive visual results are common in war-related open-globe injuries, and ocular injuries are much more severe than those held in civilian life. We think that surgical treatment urgently needs to be done in war-related open globe injuries and these patients can refer to advanced centers after surgical repairment. We consider that because the severity of ocular injuries was very high in our study, most of our patients had unfavorable visual outcomes in the remaining part of their lives, despite of immediate surgical treatment. Our study is the first clinical practice on open globe eye injuries during Syrian Civil War. In conclusion, we believe that we can draw attention to the tragedy that is going on in Syria as a result of the violent civil war.

Open-Globe Eye Injuries and Choice of Muscle Relaxant: A Review of the Evidence

A goal of treatment of open-globe eye injuries is preventing rises in intraocular pressure and the resulting loss of vitreous humor fluid from the eye globe. Surgical repair of these injuries often requires general anesthesia and tracheal intubation. Normal intraocular pressure is 10-22 mm Hg, with variations between daytime and nighttime values. Factors such as eye muscle structure, fluid volume in the eye, overall hemodynamic status, blood acidity, and mechanical pressure collectively contribute to fluid pressure within the eye. One factor that has been shown to be strongly correlated with increased intraocular pressure is elevated venous pressure with physiological conditions during tracheal intubation (eg, straining, coughing, bucking). To determine intubation best practices, we reviewed the literature on succinylcholine, a depolarizing neuromuscular blocking agent, and nondepolarizing neuromuscular blocking agents. Research and case reports have not shown an association between the loss of ocular contents and succinylcholine administration. However, succinylcholine has been associated with increased intraocular pressure after administration and intubation. Nondepolarizing neuromuscular blocking agents, particularly rocuronium, administered before or instead of succinylcholine, have been found to attenuate the rise in intraocular pressure after induction and intubation.

Characteristics of Open-globe Eye Injuries with Respect to Zone of Injury

Aims: To describe the demographics, characteristics and outcomes of open -globe injuries (OGI) with respect to zone of injury. Methods: Medical records of all patients presenting with OGIs to University Hospita l, Newark, NJ between January 2001 and December 2008 with a follow-up of at least 3 months were reviewed. Demographics, characteristics of the trauma and outcomes were compared with respect to the zone of injury; location of injury is confined to the corn ea and limbus in zone 1 (Z1), 5mm posterior to the limbus in zone 3 (Z3). Results:Of the 309 patients (310 eyes) identified, 228 (74%) were male. The mean age at presentationwas 35.3years (1-96). Meanfollow-up was 22.8 months (3-108 months). Most of the eyes presented with Z1 injury: 141 eyes (46%) Z1 injury, 83 (27%)Z2 and 86 (28%) Z3. Rupture was the most common type of injury in Z2 and Z3 injuries. Nineteen (86%) of 22 eyes with an intraocular fore ign body(IOFB) had a Z1 injury. 32 (42%) of 77 eyes with Z3 injury had no light perception (NLP) at presentation, compared with 9 (8%) of 119 Z1 and 13 (17%) of 78 Z2 -injured eyes. Four percent of Z1, 11% of Z2 and 18% of Z3-injured eyes had a final visi

The management of open globe eye injuries: a discussion of the classification, diagnosis and management of open globe eye injuries

Eye injuries occurred in 10% of UK military major trauma cases in Iraq and Afghanistan between 2004 and 2008, with 33% of these eye injuries open globe in nature(1). This article will consider the diagnosis, classification and management of open globe injuries in the role 1/ pre-hospital environment.

OPEN GLOBE OCULAR TRAUMA

To evaluate characteristics and prognostic factors for functional success in eyes that present with no light perception (NLP) after open globe trauma. The medical records of all subjects presenting to a single university referral center with visual acuity (VA) of NLP after sustaining an open globe eye injury from January 1, 2001, through June 30, 2010, were retrospectively analyzed to determine epidemiologic and clinical factors associated with visual outcomes. Of the 73 NLP eyes (73 patients) that underwent primary repair and were included in the study, final VA was 20/100 in 1 eye (1%), counting fingers in 2 eyes (3%), hand motion in 9 eyes (12%), light perception in 5 eyes (7%), and NLP in 56 eyes (77%). Recovery of some vision on postoperative Day 1, pars plana vitrectomy operation, and Zone 2 injury were significantly associated with an improvement in final VA. Zone 3 injuries were the most likely to result in NLP final VA, although this difference was not statistically significant. Visual recovery to light perception or better on postoperative Day 1 increases the likelihood of having a long-term improvement in VA. Pars plana vitrectomy may be beneficial in such eyes if posterior segment abnormalities are noted.

23-gauge vitrectomy assisted by combined endoscopy and a wide-angle viewing system for retinal detachment with severe penetrating corneal injury: a case report

BackgroundWe report a case of traumatic retinal detachment in an eye with severe corneal opacity that was successfully treated using 23 gauge (G) transconjunctival vitrectomy assisted by endoscope and a wide-angle viewing system.Case presentationA 22-year-old Japanese man was referred to our hospital with the suspicion of traumatic retinal detachment of the right eye, 1 month after an open globe eye injury due to fireworks. At the time of his first visit, his best-corrected visual acuity was hand motion in the right eye. A 23 G three port pars plana vitrectomy was conducted in combination with ophthalmic endoscope and a wide-angle viewing system. Endoscopy revealed a retinal detachment in the inferior quadrant with tiny retinal breaks. Primary reattachment of the retina was achieved by tamponade of SF6 gas. Five months after the vitrectomy, penetrating keratoplasty was performed and visual acuity recovered to 0.02. Optical coherent tomography revealed thinning of the retina, which might be the cause of the remaining poor vision.Conclusion23 G vitrectomy assisted by combined endoscopy and a wide-angle viewing system could be advantageous in managing visualization constraints due to penetrating trauma.

Influence of alcohol consumption on incidence and severity of open-globe eye injuries in adults

To investigate the influence of alcohol consumption on the occurrence of open-globe injuries in adults. A retrospective study was made of 100 consecutive patients (81 male, 19 female) with open-globe injuries. Of these patients, 18 exhibited alcohol intoxication (group Ai), and 82 exhibited no alcohol intoxication (group nAi). Investigated parameters were best-corrected visual acuity at day of admission and last examination (logMAR), type of injury according to BETT-classification, extraocular injuries, cause of injury, time and setting of injury, in relation to alcohol consumption and tested for statistical significance with Fisher's exact test or the Mann-Whitney U test, respectively. In group Ai, 83.3% of the patients were male, and in group nAi, 80.5%. Mean logMAR at day of admission was 1.06 ± 0.63 (20/250) in group Ai and 1.08 ± 0.59 (20/250) in group nAi. At last examination, mean logMAR in group Ai was 1.11 ± 0.59 (20/250), in group nAi 0.75 ± 0.60 (20/125). This difference was statistically significant (p = 0.02). In group Ai, significantly more ruptures according to BETT classification occurred (p = 0.05). In group Ai, significantly more additional extraocular injuries occurred compared to group nAi (38.9% versus 6.1%; p = 0.0009). In group Ai, the cause of injury was significantly more often glass (44.4% versus 2.4%; p = 0.0000), in group nAi the injury was more often directly or indirectly caused by tools (74.4% versus 33.3%; p = 0.001). In group Ai, the injury was significantly more often inflicted by others (50.0% versus 9.8%; p = 0.0003). The settings in which the injuries occurred were significantly more often the street in group Ai (44.4% versus 6.1%; p = 0.0002), in group nAi the garden or tool shed (31.7% versus 5.6%; p = 0.02) or the workplace (34.2 % versus 11.1 %; p = 0.04). In group Ai, the injuries occurred significantly more often at night (p = 0.0001) and on weekends (p = 0.0000). Open-globe eye injuries under alcohol intoxication are more often caused by a third party and have a worse prognosis. Open-globe injuries under alcohol intoxication occur in a different spatio-temporal setting and exhibit a more severe type of injury. Risk behavior combined with alcohol consumption therefore seems to be an independent factor for the incidence of open-globe eye injuries.

Wartime open globe eye injuries

Open globe injuries are the most serious eye injuries in war as in peace time. The purpose of this study is to analyze wartime open globe eye injuries in 72 patients treated at the Department of Ophthalmology, Clinical Hospital of Split from July 1991 to April 1993, during the intensive war in Croatia and Bosnia and Herzegovina, and to evaluate crucial factors responsible for the functional success of the treatment. Wartime open globe eye injuries were retrospectively analyzed in 72 patients (80 eyes) hospitalized at Clinical Hospital of Split, Department of Ophthalmology, between July 1991 and April 1993. The causes and ways of wounding, localization of wounds and presence, nature and localization of the foreign body, as well as admission time, microsurgical management and other factors contributing to poor visual outcome were studied. Standard international classification of ocular traumas (the Birmingham Eye Trauma Terminology and the International Ocular Trauma Classification) was used for the classified and graded injuries. Open globe eye injuries amounted to 52.65% of all war injuries to the eyes. Bilateral injuries were found in eight patients (11.11%). The most frequent cause of the injures were fragments of explosive devices (more than two-thirds). Most of the patients were admitted to the hospital within 24 hours of the injury. Using current microsurgical techniques, the attempt was made to achieve not only anatomical but also functional recovery already in the primary treatment. In 30 eyes (37.50%) final visual acuity amounted to more than 0.1, and in 22 eyes (27.50%) it reached 0.5. There was a statistically significant correlation between admission within the first 12 hours and postoperative improved visual acuity (chi(2) = 4.53; p = 0.033). Statistically significantly better visual acuity was found in patients with lesions limited to the anterior segment of the eye. Primary enucleation or evisceration was performed only exceptionally: one enucleation and six eviscerations (8.75%). The most important factors in the prognosis of postoperational visual acuity for wartime open globe eye injuries were: (1) preoperative condition of the eye, (2) localization and extent of the wound, (3) presence, size and nature of foreign bodies, and (4) adequate surgical treatment in specialized institutions.

Severe open-globe eye injuries: socio-demographic aspects and risk factors

To evaluate sociodemographic aspects and risk factors of severe open-globe ocular injuries. We present data from prospective study of 315 patients with severe open-globe ocular injuries, meeting inclusion criteria. The patients in our series were predominantly male (92.70%). The male to female ratio was 12.7:1. Almost 27% of the patients were from the age group of 30-39 years. Home (53.65%), streets and highways (19.05%) were the most common place of injury, followed by industrial premises (11.11%), agricultural activities (8.25%), recreation and sports (5.40%); 15.56% of cases were work-related. Sharp objects (43.17%) and hammering on metal (24.44%) were the two major causes of injury. Alcohol intoxication was observed in 13.65% of cases. Severe open-globe eye injuries were classified into four categories: penetrating injuries (56.83%), perforating injuries (2.54%), globe ruptures (12.38 %), and IOFB injuries (28.25%). Males suffered significantly more often than females in the age of 20-29 (OR=1.39+/-95% CI 1.10-1.75, P<0.01) and 30-39-year (OR=1.75+/-95% PI 1.45-2.22, P<0.01). Risk factors of severe open-globe eye injuries for male gender were living in urban setting (P=0.001), alcohol use (P=0.001), occupation--unemployed (P=0.001) and retired persons (P=0.011). Risk factors for male gender to sustain severe open-globe eye injury were living in urban setting, alcohol use, and occupation (unemployed and retired persons).