Missed ocular perforations after road traffic accidents

Soni, Kiran; Eustace, P.

doi:10.1016/s0020-1383(72)80017-2

Cited by 5 publications

(4 citation statements)

References 2 publications

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“…This is supported by the fact that it is not uncommon for certain injuries to go undetected, even during secondary evaluation . Eye trauma in particular can be difficult to detect because of periorbital swelling that complicates examination of the eye and/or unconsciousness in the patient, which creates the inability to assess visual acuity . Excluding secondary eye trauma would therefore underestimate the true health care burden of eye injuries.…”

Section: Introductionmentioning

confidence: 99%

Changes in the Incidence of Eye Trauma Hospitalizations in the United States From 2001 Through 2014

et al. 2019

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IMPORTANCE Eye trauma is a common cause of vision loss and a substantial public health problem.OBJECTIVE To determine the changes in the incidence of eye trauma hospitalizations in the United States and compare the demographics of affected patients and outcomes of eye trauma as a primary or secondary admitting diagnosis. DESIGN, SETTING, AND PARTICIPANTSThis retrospective longitudinal cohort study used the National Inpatient Sample, a representative sample of all US community hospitals, to determine the incidence, characteristics, and causes of primary and secondary inpatient eye trauma admissions from 2001 through 2014. All inpatients with relevant diagnoses were included. Linear regression was used to estimate changes in incidence. Logistic regression was used to compare demographics and outcomes between primary and secondary diagnoses, including age, sex, race, income, primary payer, region, year of admission, length of stay, cost, and disposition at discharge. EXPOSURES Eye trauma.MAIN OUTCOMES AND MEASURES Incidence and characteristics of inpatient primary and secondary eye trauma. RESULTSFrom 2001 to 2014, there were an estimated 939 608 inpatient admissions (of whom 556 886 were male patients [59.3%]; overall mean [SD] age, 49.4 [25.2] years) in the United States because of eye trauma diagnoses, with 778 967 of these (82.9%) as a secondary diagnosis. The incidence of primary eye trauma decreased from 3.9 to 3.0 per 100 000 population (difference, 0.9 [95% CI, 0.2-1.6] per 100 000 population; P = .001). The incidence of eye trauma as a secondary admitting diagnosis increased from 14.5 to 19.0 per 100 000 population (difference, 4.5 [95% CI, 1.9-7.2] per 100 000 population; P = .004). This was largely attributed to an increasing number of falls in individuals older than 65 years. The most frequent diagnosis was orbital fracture (64 149 [39.9%]) for primary trauma and contusion of eye and adnexa (19 301 [37.8%]) for secondary trauma. Primary trauma was more common in children (adjusted odds ratio [aOR], 2.21 [95% CI, 2.09-2.32]) and adolescents (aOR, 1.25 [95% CI,) than adults (reference), African American individuals (aOR, 1.89 [95% CI, 1.81-1.97]) and Hispanic individuals (aOR, 1.52 [95% CI, 1.45-1.59]) than white individuals, and uninsured patients (aOR, 1.14 [95% CI, 1.07-1.22]) and those receiving Medicaid (aOR, 1.12 [95% CI, 1.05-1.19]) than Medicare beneficiaries. Patients with a primary diagnosis were more likely to have a stay of less than 3 days (patients with a primary diagnosis: 101 796 [63.4%]; secondary diagnosis: 274 538 [35.2%]), more likely to have costs in the lowest quartile (patients with a primary diagnosis: 51 212 [31.9%]; secondary diagnosis: 166 260 [21.3%]), and less likely to die (patients with a primary diagnosis: 526 [0.3%]; secondary diagnosis: 20 929 [2.7%]).CONCLUSIONS AND RELEVANCE These findings suggest that the increasing number of falls in individuals older than 65 years and the high risk of primary eye trauma in populations such as children and adolescents warrant the devel...

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Section: Introductionmentioning

confidence: 99%

Changes in the Incidence of Eye Trauma Hospitalizations in the United States From 2001 Through 2014

et al. 2019

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“…Furthermore, undetected or missed injuries are not uncommon, even during the secondary evaluation of polytrauma patients [1]. For eye injuries in particular this is due to periorbital swelling that makes examination of the eye difficult and, therefore, injuries such as globe perforations can be missed [2]. Radiological imaging may not detect such injuries.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of ocular and orbital injuries in polytrauma patients

Georgouli

Pountos

Chang

et al. 2010

Eur J Trauma Emerg Surg

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“…Ocular trauma is common among these patients and is associated with vision-threatening pathology [6][7][8][9][10][11]. However, these injuries are often missed as primary surveys prioritise life-threatening pathology, and examination of the visual system in these patients, who are often unconscious or have concurrent periorbital injuries, is challenging [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Ocular injuries among patients with major trauma in England and Wales from 2004 to 2021

Bashir,

Bouamra,

Kirwan

et al. 2024

Eye

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Background Ocular trauma is a significant cause of blindness and is often missed in polytrauma. No contemporary studies report eye injuries in the setting of severe trauma in the UK. We investigated ocular injury epidemiology and trends among patients suffering major trauma in England and Wales from 2004 to 2021. Methods We conducted a retrospective study utilising the Trauma Audit and Research Network (TARN) registry. Major trauma cases with concomitant eye injuries were included. Major trauma was defined as Injury Severity Score >15. Ocular injuries included globe, cranial nerve II, III, IV, and VI, and tear duct injuries. Orbital fractures and adnexal and lid injuries were not included. Demographics, injury profiles, and outcomes were extracted. We report descriptive statistics and 3-yearly trends. Results Of 287 267 major trauma cases, 2368 (0.82%) had ocular injuries: prevalence decreased from 1.87% to 0.66% over the 2004–2021 period (P < 0.0001). Males comprised 72.2% of ocular injury cases, median age was 34.5 years. The proportion of ocular injuries from road traffic collisions fell from 43.1% to 25.3% while fall-related injuries increased and predominated (37.6% in 2019/21). Concomitant head injury occurred in 86.6%. The most common site of ocular injury was the conjunctiva (29.3%). Compared to previous TARN data (1989–2004), retinal injuries were threefold more prevalent (5.9% vs 18.5%), while corneal injuries were less (31.0% vs 6.6%). Conclusions Whilst identifying eye injuries in major trauma is challenging, it appears ocular injury epidemiology in this setting has shifted, though overall prevalence is low. These findings may inform prevention strategies, guideline development and resource allocation.

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Missed ocular perforations after road traffic accidents

Cited by 5 publications

References 2 publications

Changes in the Incidence of Eye Trauma Hospitalizations in the United States From 2001 Through 2014

Changes in the Incidence of Eye Trauma Hospitalizations in the United States From 2001 Through 2014

Prevalence of ocular and orbital injuries in polytrauma patients

Ocular injuries among patients with major trauma in England and Wales from 2004 to 2021

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