Epidemiology of Blindness From Facial Trauma: A Multi-Centre Nigerian Study

Abstract

Study Design This is a multi-centre retrospective study. Objective To determine the prevalence of blindness and pattern of facial trauma associated with blindness among Nigerians. Methods A multi-centre retrospective study of all patients with facial trauma resulting in blindness, that were co-managed by maxillofacial surgeons and ophthalmologists in 4 Nigerian public tertiary hospitals between January 2010 and December 2019 was undertaken. Data was analysed by IBM SPSS Statistics (version 21.0 for windows, IBM© Inc, Chicago, IL). Results Of 2070 patients who presented with major facial injuries during the study period, 61 eyes of 56 (2.7%) patients were blind. Blindness was bilateral and unilateral in 5 (8.9%) and 51 (92.1%) patients, respectively. The mean age (SD) at presentation was 36.2 (16.6) years, and 47 (83.9%) of these patients were males. Road traffic accident (n = 27; 48%) was the commonest mechanism of facial trauma, the cheek (n = 18; 40.9%) was the commonest site of associated soft tissue injury and zygomatic complex fracture (n = 19; 24.1%) was the commonest related fracture. Globe rupture (n = 34; 55.7%) was the leading cause of blindness. Enucleation (n = 7; 13.2%) and evisceration (n = 22; 41.5%) were performed on 29 eyes of which 12 (41.4%) patients had ocular prosthesis post-operatively. Conclusion Blindness was recorded in 2.7% of Nigerians with facial trauma. The commonest mechanism of trauma and cause of blindness in at least one eye were road traffic accident and globe rupture, respectively. Eye removal surgery was necessary in about half of the blind eyes.

The global incidence and disability of eye injury: an analysis from the Global Burden of Disease Study 2019

“…Road traffic accidents are the most common mechanism of facial trauma and cause of blindness in at least one eye. 11 Many factors are associated with an increased risk of traffic accidents, including improved expressways and hence, increased vehicular movement, particularly in low and middle-income countries. It is recommended to implement preventive strategies such as legislation enforcing road traffic safety measures.…”

“… 7 Previous studies have indicated that an increase in both the age-standardised rates (ASR) of incidence and number of years lived with disability (YLDs) from eye injuries due to intraocular foreign bodies are going to present a global health challenge. 8 , 9 In addition to foreign body injuries, there are many causes of eye injuries, such as explosive eye injuries, 10 road traffic injuries, 11 mechanical or non-mechanical eye injuries (chemical/thermal/radiation), 12 and even self-inflicted injuries. 13 However, the incidence of and burden from eye injury have not been reported, and there has been no information regarding age-, sex-, spatial-, and temporal patterns of eye injury worldwide.…”