Associations between socioeconomic status and open globe injury

To examine associations between socioeconomic status (SES), as evaluated by the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI) and Distressed Communities Index (DCI), and the characteristics of open globe injury (OGI).

Retrospective review of electronic medical records for patients treated for OGI at an academic Level I trauma centre between May 2009 and March 2021. Patient data included age, date of injury, mechanism of injury, visual acuity at presentation, concomitant orbital wall fracture, and ocular trauma score (OTS). The SVI and DCI scores were obtained based on the patient's home zip code. Patients were classified based on individual mechanisms of injury and grouped into non-accidental vs. accidental cases.

899 patients (75.0% male) were included. Average ± SD age (years), SVI, and DCI scores were 44.8 ± 22.7, 0.418 ± 0.207, and 37.9 ± 24.0, respectively. Younger age was associated with higher DCI and lower OTS score (p ≤ 0.002). Non-accidental trauma patients had lower OTS and higher SVI and DCI scores compared to accidental trauma (p < 0.001); firearm-associated ocular injuries (FAOIs) were associated with higher SVI and DCI scores (p < 0.001 and p = 0.040, respectively); domestic violence/assault was associated with worse OTS and higher DCI (p < 001). Falls and sports-related injuries correlated with lower DCI scores (p ≤ 0.031).

In our region, among patients with OGIs, lower SES scores were associated with younger age, FAOIs, and non-accidental injuries, including domestic violence/assault. Therefore, lower SES may be considered a risk factor for several distinct mechanisms of OGI.