No abstract

No abstract

Importance Childhood ocular injury is a common, preventable cause of potentially severe permanent disability. Background This study evaluates the nationwide incidence, demographics and visual outcomes of children with ocular injury in New Zealand. Design Nationwide retrospective review. Participants All children in New Zealand aged 0 to 17 years from 2007 to 2016 with ocular injury requiring assessment by a medical practitioner. Methods New Zealand national and regional datasets were used to evaluate population‐level statistics for ocular injury over a 10‐year period. Visual and clinical outcome data were assessed using a randomized sample of 150 patients. Main Outcome Measures Annual incidence, aetiology, demographics, injury location, visual outcomes, protective eyewear use, surgical intervention and follow‐up. Results A national total of 75 601 cases were included with a mean incidence of 719/100 000 children/year. Cases were predominantly male (63.2%) and of New Zealand‐European ethnicity (60.8%), aged 0 to 4 years (30.66%). Injury cause was most commonly “struck by object” (53.7%) and occurred in the home (50.9%). Tertiary hospital assessment and treatment was required in 17.7% where final visual acuity of 6/12 or worse was noted in 19.7% and protective eyewear use was reported in 2.7%. Maori and Pacific ethnicities were associated with higher rates of permanent visual impairment. Conclusions and Relevance Children with the highest risk of ocular injury are males aged 0 to 4 years. Children of Maori or Pacific Island ethnicity and aged 15 to 17 years have the highest risk of ocular injury resulting in permanent visual impairment. Protective eyewear use is uncommon in children presenting with ocular injury. Promotion of appropriate injury prevention strategies is an important public health message.

Importance Ocular injury is a common, preventable cause of temporary and permanent disability. Background The current study evaluates the nationwide incidence, demographics and visual outcomes of adults with ocular injury in New Zealand. Design Nationwide retrospective review. Participants New Zealanders aged 18‐99 years from 2007 to 2016 with ocular injury requiring assessment by a registered medical practitioner. Methods New Zealand national and regional datasets were used to evaluate population‐level statistics over a 10‐year period. Visual and clinical outcome data were assessed using a random sample of 150 patients from a tertiary hospital. Main Outcome Measures Annual incidence, aetiology, demographics, injury location, visual outcomes, protective eyewear use, surgical intervention and follow‐up. Results A total of 332 418 adult eye injuries were recorded nationally. The annual incidence of eye injury was 1007/100 000 population/year. Patients were predominantly male (76.1%), of New Zealand‐European ethnicity (74.6%) and aged between 20 and 29 years (21.1%). The most common mechanism of injury was “struck by object” (55.4%). Injuries occurred most commonly at home (48.4%), followed by commercial (15%) and industrial locations (13.8%). Injuries were more common in rural regions (P < .001). Protective eyewear use was reported in 6% of cases (n = 9, 95% confidence interval = 3.2‐11.0). Most ocular injuries were managed exclusively in primary care (70.5%). Conclusions and Relevance Adults with the highest risk of ocular injury are rural males aged 20 to 29 years. Protective eyewear use is uncommon in adults presenting with ocular injury and the majority of injuries are managed in primary care. Promotion of appropriate injury prevention strategies is an important public health message.

No abstract

The purpose of this study was to evaluate any alterations in the tear film and ocular surface beyond the early postoperative period following penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK). This cross-sectional, contralateral-eye study compared ocular surface and tear film parameters of eyes with a previous PK or DALK in one eye and no prior surgery in the contralateral eye. Overall, 14 (87.5%) participants underwent PK, and 2 (12.5%) underwent DALK using a mechanical dissection. The median time from surgery was 3.4 years (range 1.5 to 38.7 years). The indication for unilateral keratoplasty was keratoconus in 15 (94%) participants, and corneal scarring in 1 (6%) eye, secondary to microbial keratitis. Operated eyes exhibited poorer non-invasive tear film breakup time, lower corneal sensitivity, lower sub-basal nerve density and more severe fluorescein staining scores than unoperated fellow eyes (all Q < 0.05). There were no significant differences in tear film lipid layer quality, tear meniscus height, conjunctival hyperaemia, lissamine green staining score, or meibography grade between operated and fellow eyes (all Q ≥ 0.20). Higher corneal esthesiometry threshold (lower corneal sensitivity) was correlated with shorter non-invasive tear film breakup time (Spearman’s rho =  − 0.361, p = 0.04) and increased fluorescein staining score (Spearman’s rho = 0.417, p = 0.02). Keratoplasty can induce persistent changes in the ocular surface and tear film, including: increased fluorescein staining, decreased tear film breakup time, decreased corneal sub-basal nerve plexus density, and reduced corneal sensitivity.

No abstract