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Temporal and Seasonal Trends in Pediatric Eye Trauma in California
Marinia N Bishay1, Albert Xu2, John M Nesemann2
1School of Medicine, Meharry Medical College, Nashville, TN, USA.
Insights
Pediatric eye trauma emergency department visits decreased from 2016-2021 in California, showing seasonal trends. Higher rates were seen in males and minority children, with peak incidence in May.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- Pediatric ocular trauma is a significant public health concern.
- Understanding temporal and seasonal trends in pediatric eye injuries is crucial for targeted prevention strategies.
Purpose of the Study:
- To evaluate temporal and seasonal trends in pediatric eye trauma using emergency department (ED) visit data in California.
- To identify demographic and geographic factors associated with pediatric ocular trauma.
Main Methods:
- Retrospective, population-based cohort study utilizing California Department of Health Care Access and Information datasets (2016-2021).
- International Classification of Diseases (ICD) codes were used to identify pediatric ocular trauma cases among emergency department visits.
- Poisson regression analysis modeled yearly incidence and assessed seasonal patterns.
Main Results:
- Ocular trauma accounted for 1.0% of pediatric ED visits (160,730 cases) in California between 2016 and 2021.
- The overall yearly incidence of pediatric eye trauma decreased significantly from 3.4 per 1000 children in 2017 to 2.1 in 2020.
- Higher incidence rates were observed in male children and those identifying as Black and Hispanic/Latino, with a seasonal peak in May and lowest incidence in January.
Conclusions:
- Pediatric ocular trauma represents a small but notable proportion of ED visits, with a declining incidence over the study period.
- Significant seasonal variations in pediatric eye trauma incidence were identified, suggesting environmental or behavioral influences.
- Targeted interventions may be necessary for male children and specific racial/ethnic groups to reduce the burden of pediatric eye injuries.
Purpose:
This study aims to evaluate temporal and seasonal trends in pediatric eye trauma based on emergency department (ED) visits in California.
Design:
Retrospective, population-based cohort study.
Methods:
Children who presented with ocular trauma to EDs in California between 2016 and 2021 were identified using the California Department of Health Care Access and Information datasets and classified by International Classification of Diseases (ICD) diagnosis codes. Poisson regression was used to model yearly incidence and seasonality was assessed.
Results:
Among 15,674,366 ED visits by children in California from 2016 to 2021, 160,730 (1.0%) involved a primary or secondary diagnosis of ocular trauma. The mean age at presentation was 7.6 (SD: 5.6) years. The most common diagnoses were ocular adnexal open wound (51.4%) and superficial injury of the eye/adnexa (23.6%). The overall yearly incidence of eye trauma was 3.0 (95% CI: 3.0-3.0) per 1000 children, peaking in 2017 (3.4) and lowest in 2020 (2.1) and significantly decreased over the study period. Male children and Black and Hispanic/Latino children had the highest incidence of ocular trauma. A significant seasonal pattern was observed, with the highest incidence in May and the lowest in January (P<0.01). Geographically, the highest incidences were in the Inland North and Central Valley regions. Over the 6-year period, the percentage of self-pay (uninsured) pediatric patients decreased over time, and public insurance (Medicaid/Title V) remained the most common payor.
Conclusion:
Ocular trauma represents a small fraction of ED visits for children in California. The incidence of ocular trauma ED visits decreased over the study period and displayed a seasonal trend. Higher incidence of ocular trauma were observed in male and Black and Hispanic/Latino children.
