Epidemiology of adult eye injuries in Split-Dalmatian county

To determine the incidence of eye injuries, population groups at risk, circumstances and activities at the time of accident, causes, mechanism, type and severity of injury, therapeutic procedures, final outcome, and the incidence of blindness in patients over 18 years of age.

We retrospectively analyzed data on 383 patients with eye injuries (397 eyes) hospitalized at Split University Hospital, Department of Ophthalmology, between January 1998 and December 2002. Standardized international classification of ocular trauma (Birmingham Eye Trauma Terminology) and eye injury score were used for eye injury categorization.

The incidence of ocular injuries requiring hospitalization in Split-Dalmatian County was 23.9 per 100,000 population and the incidence of monocular blindness caused by injuries was 4.1 per 100,000 population. The male to female ratio was 5.4 to 1. Forty-one percent of injuries occurred at home, 27.7% at work, 13.8% in agriculture, 7.0% during assault or scuffle, 5.2% in traffic, 3.7% during sports activities, and 1.6% at school. Among 397 injuries, 86.4% were mechanical and 13.6% chemical. Out of 343 mechanical injuries, 67.3% were closed globe and 32.7% were open globe injuries. The most frequent objects causing mechanical injuries were tree branch or wood (15.9%) causing 26.3% of ruptures and 21.4% of contusions; pieces of metal or stone (13.9%) causing 80.8% of intraocular foreign body lacerations; and nails, wire, or scissors (8.8%) causing 26.7% of lamellar and 23.9% of penetrating lacerations. Closed globe injuries were less severe and had better final visual outcome than open globe injuries. Final visual acuity was 0.4 or better in 91.4% of mild vs 13.9% of severe injuries. Injuries resulted in monocular blindness (visual acuity <0.1) in 71 (17.9%) patients: 35.2% were due to penetrating lacerations, 23.9% to ruptures, 21.1% to contusions, 16.9% to intraocular foreign body lacerations, and 1.4% due to burns as well as lamellar lacerations.

There was a high incidence of ocular trauma and consequent blindness in Split-Dalmatian County. For the prevention of serious eye injuries, health education and safety strategies should be applied both at home and place of work, where blinding injuries most often occur.