Cellphone-Associated Ocular Injuries Presenting to U.S. Emergency Departments

To characterize national trends, mechanisms, and demographic patterns of cellphone-associated ocular injuries over 20 years using a nationally representative database.

Retrospective cross-sectional study using the National Electronic Injury Surveillance System (NEISS) database, encompassing emergency department (ED) visits from approximately 100 nationally representative U.S. hospitals. Cellphone-associated eye injuries, which encompass cases of globe injury where cellphones or their accessories were involved, were identified and analyzed for patient demographics, clinical information, context of injury, and weighted national estimates. Temporal trends in ED visit rates were analyzed using joinpoint regression, and annual percent changes (APCs) quantified changes in ED visit rates.

Between 2004 and 2023, an estimated 16,107 ED visits from cellphone-associated eye injuries (95% CI, 13,280-18,933) were recorded in NEISS. By joinpoint analysis, ED visit rates increased significantly from 2008-2015 (APC, 22.4%; 95% CI, 9.7%-36.5%), and no statistically significant trend was observed from 2004-2008 (APC, 1.0%; 95% CI,15.9%-21.2%) or from 2015-2023 (APC, -3.9%; 95% CI, 12.1%-5.1%). Open globe injuries occurred in seven reported cases, representing 252 weighted-estimated ED visits (95% CI, 33-471) or 1.6% of all estimated ED visits. Direct mechanical (DM) injuries accounted for 83.2% (weighted n = 13,401, 95% CI, 11,002-15,800) of ED visits, predominantly from the phone body (46.2%) and screen glass (32.6%). Use-associated (UA) injuries comprised 16.8% weighted (n = 2,705, 95% CI, 1,641-3,770), with distraction-mediated activities (62.7%) being most common.

Cellphone-associated ocular ED visits increased substantially from 2008 to 2015, while no statistically significant change was detected between 2015 and 2023. Direct mechanical trauma, broken screen glass, and distraction represent commonly identified mechanisms. Eye care professionals should counsel patients on responsible handling of phones and accessories, limiting phone use while walking or driving, replacement of broken screens, and the importance of prompt assessment after penetrating or significant ocular trauma.