Behavioral Health Status after Globe Removal in United States Service Members

Area of Science:

• Ophthalmology
• Psychiatry
• Military Health

Background:

• Globe removal (GR) is a significant ocular injury.
• Behavioral health (BH) conditions can arise after trauma.
• Understanding the incidence of new BH diagnoses post-GR is crucial for military service members.

Purpose of the Study:

• To determine the incidence of new behavioral health (BH) diagnoses in patients who underwent globe removal (GR) within the Military Health System (MHS).

Main Methods:

• Retrospective cohort study of active-duty service members (SMs) in the MHS from 2017-2022.
• Utilized the MHS Mart (M2) database for patients undergoing GR secondary to trauma.
• Multivariate Poisson regression analyzed the relative risk (RR) of new BH diagnoses post-GR, excluding patients with prior BH diagnoses.

Main Results:

• 103 patients underwent GR; 27 developed new BH diagnoses post-GR.
• GR patients showed significantly increased RR for: suicide/ideation (47.2), alcohol use disorder (17.3), anxiety (12.8), adjustment disorder (10.5), substance use disorder (5.29), and depression (8.0).
• New BH diagnoses occurred much sooner post-GR (median 49 days) compared to pre-existing BH diagnoses (median 351 days).

Conclusions:

• Patients undergoing GR have a substantially elevated risk of new BH diagnoses, particularly suicidal ideation and substance use disorders.
• The findings underscore the importance of proactive behavioral health screening for individuals following globe removal.
• Early identification and intervention for BH conditions are critical in this population.