Open globe injuries: epidemiological study of two eye clinics in Germany, 1981-1999

To analyze the epidemiology of open eye globe injuries and their treatment outcomes in patients treated at two university eye clinics in Germany in the past two decades.

Retrospective analysis was performed of medical records of 1,026 patients with open globe injuries primarily treated at the Universities of Freiburg and Wurzburg between January 1981 and December 1999. Final visual function was determined as a parameter of age, extent of injury, sex, cause of injury, and activity at the time of injury. Relative risk was calculated.

After correction for the demographic distribution, the risk for open globe injury was 1.7 times the average for young adults and 0.6 for seniors. In the recent years, the risk for severe eye injury has been more equally distributed and is increasing for old people. The proportion of injuries at work decreased over the studied period from 42% to 32% for all open globe injuries, and the proportion of injuries in traffic accidents decreased from 30% to 4%. The number of eye injuries related to hobby activities increased. The proportion of enucleations and blindness decreased. Social life and income was moderately or severely impaired in 27% of patients after severe unilateral eye trauma. The median follow up of patients was 7 months.

The prevalence and types of open globe injuries changed over the years, especially in relation to the law requiring seat belt use in traffic. The progress in surgical techniques led to a significant reduction in the number of blind eyes after injury. The proportion of enucleations and blindness decreased partly due to better surgical techniques, but mostly due to the decrease in injuries with usually poor outcome, such as gunshots, ruptures, and windscreen injuries.