Open globe injuries in patients seen at Groote Schuur Hospital, Cape Town, South Africa

Ocular trauma accounts for a significant proportion of admissions to the eye ward at Groote Schuur Hospital (GSH), Cape Town, South Africa. There are few published studies on ocular trauma in South Africa. Some studies elsewhere have shown an association between open globe injuries and recent alcohol use, but no such study has been conducted in this country.

To identify causes of and outcomes after open globe injuries at GSH, with emphasis on the association between assault and alcohol use as well as the relationship, if any, between victim and assailant.

This was a prospective case series of all adult patients admitted to GSH with open globe injuries over a 2-year period. Ocular findings were recorded with a minimum 3-month follow-up period.

There were 249 open globe injuries. Assault had occurred in 183 (73.5%), and 66 (26.5%) were accidental. In the assault-related cases, 95 (51.9%) of the assailants were reported to have used alcohol and 121 (66.1%) of the victims admitted to alcohol use prior to the assault. There was a statistically significant relationship between ethanol use and type of injury, 71.4% of assault cases overall being associated with ethanol use. In assault-related cases, the assailant was known to the victim in 113 cases (61.7%). Of the patients, 78.7% had a final acuity of <3/60 in the traumatised eye.

A significant number of open globe injuries due to assault are related to ethanol abuse and occur when the victim and assailant are known to each other. Such injuries are likely to have a poor prognosis.