The global incidence and disability of eye injury: an analysis from the Global Burden of Disease Study 2019

Impact of social determinants of health on causes of ophthalmic trauma: A narrative review

Ophthalmic trauma (OT) is a leading cause of monocular vision loss that preferentially affects certain populations. In this narrative review, we aim to discuss the impact of social determinants of health (SDOH) on the prevalence and outcomes of OT. We conducted literature search to identify studies published between 2019 and 2024 that discuss the impact of SDOH on OT. A total of 92 studies were included. Overall, males, particularly those of younger and working age groups, are most commonly affected with OT, with assault, firearm, and occupation-related injuries being most common types of injuries encountered. In comparison, falls and intimate partner violence are the most common causes in women. Children are more prone to toys, sports, and firework-related injuries, while falls represent the leading cause in the elderly frequently resulting in open globe injury. Black and Hispanic individuals suffer disproportionately from assault and firearm-related injuries. Unemployed individuals and those of rural residence and low socioeconomic status have higher rates of OT. Our review underscores the impact of demographic, social, and economic factors on the risk and outcomes of OT and its subtypes. Only by understanding the patterns, targeted interventions and policy changes can be undertaken to address these disparities.

Global Burden of Eye Injuries in Children and Adolescents, 1990-2021: A Systematic Analysis from the Global Burden of Disease Study

PURPOSE

Eye injuries are a leading cause of monocular vision impairment and disability in children and adolescents. Unlike adults, eye injuries in children exhibit significant age specificity, with worse visual outcomes due to immature vision, the risk of long-term damage, and amblyopia. However, research on the global distribution and trends of eye injury burdens in this population is limited.

DESIGN

Retrospective population-based trend study.

METHODS

This study analyzes the burden of eye injuries among children and adolescents aged 0 to 19 years globally, regionally, and nationally, using data from the 2021 Global Burden of Disease study. We evaluated the epidemiological characteristics of eye injuries by calculating incidence, years lived with disability (YLD), age-standardized incidence rates (ASIR), and age-standardized YLD rates (ASYR). Temporal trends in ASIR and ASYR from 1990 to 2021 were assessed using joinpoint regression analysis, expressed as average annual percentage changes. The analysis was further stratified by sex, age, and sociodemographic index (SDI) to explore trends in different subgroups.

RESULTS

In 2021, the global ASIR and ASYR for children and adolescents were 434·24 per 100,000 (95% confidence interval [CI], 305·17-603·22) and 3·19 per 100,000 (95% CI, 0·96-6·99), respectively, indicating a decline since 1990. Regions with high SDI showed the highest incidence of eye injuries. Australasia, Southern Latin America, and Western Europe had the highest ASIRs and ASYRs in both 1990 and 2021. From 1990 to 2021, Afghanistan, Yemen, Libya, the Central African Republic, and Chile experienced the most significant increases in pediatric eye injuries. Global data show that boys have an eye injury incidence rate approximately 1·8 times higher than that of girls. In 2021, the incidence of eye injuries among children and adolescents increased with age. The primary causes include foreign bodies, exposure to mechanical forces, and falls.

CONCLUSIONS

Despite observed declines in incidence and YLD, the burden of eye injuries in children and adolescents remains substantial. These findings underscore the urgent need for the development and implementation of targeted preventive education initiatives and ocular protection protocols on a global scale.

Anomaly Detection in Retinal OCT Images With Deep Learning-Based Knowledge Distillation

Purpose

The purpose of this study was to develop a robust and general purpose artificial intelligence (AI) system that allows the identification of retinal optical coherence tomography (OCT) volumes with pathomorphological manifestations not present in normal eyes in screening programs and large retrospective studies.

Methods

An unsupervised anomaly detection deep learning approach for the screening of retinal OCTs with any pathomorphological manifestations via Teacher-Student knowledge distillation is developed. The system is trained with only normal cases without any additional manual labeling. At test time, it scores how anomalous a sample is and produces localized anomaly maps with regions of interest in a B-scan. Fovea-centered OCT scans acquired with Spectralis (Heidelberg Engineering) were considered. A total of 3358 patients were used for development and testing. The detection performance was evaluated in a large data cohort with different pathologies including diabetic macular edema (DME) and the multiple stages of age-related macular degeneration (AMD) and on external public datasets with various disease biomarkers.

Results

The volume-wise anomaly detection receiver operating characteristic (ROC) area under the curve (AUC) was 0.94 ± 0.05 in the test set. Pathological B-scan detection on external datasets varied between 0.81 and 0.87 AUC. Qualitatively, the derived anomaly maps pointed toward diagnostically relevant regions. The behavior of the system across the datasets was similar and consistent.

Conclusions

Anomaly detection constitutes a valid complement to supervised systems aimed at improving the success of vision preservation and eye care, and is an important step toward more efficient and generalizable screening tools.

Translational Relevance

Deep learning approaches can enable an automated and objective screening of a wide range of pathological retinal conditions that deviate from normal appearance.

A Transformative Wearable Corneal Microneedle Patch for Efficient Therapy of Ocular Injury and Infection

Ocular injury and infection are significant causes of vision impairment and blindness globally. Effective treatment is, however, challenging due to the physical barrier of the cornea, which restricts drug penetration in the eye, as well as the presence of eye injury that necessitates continuous delivery of growth factors on the ocular surface for cornea healing. Here, we introduce a transformative wearable corneal microneedle (MN) patch designed for efficient therapy of ocular injury and infection. The MN patch comprises water-soluble tips that encapsulate antibacterial nanoparticles (NPs), along with a transformative backing layer that contains epidermal growth factor (EGF). Upon insertion into the eye, the MN tips dissolve swiftly within the cornea stroma, resulting in the release of the antimicrobial NPs to efficiently eradicate bacteria. Meanwhile, the residual backing layer undergoes rapid in situ transformation upon contact with mildly acidic fluid from infected corneal edema, converting into a contact lens that conforms to the eye's surface, which facilitates sustained release of EGF on the ocular surface over 8 h to promote corneal healing. Benefiting from these features, the designed transformative corneal MN patch demonstrates superior efficacy in treating ocular injuries and infections in vivo, offering a promising therapeutic strategy to manage eye diseases.

Predictors of higher pain in possible open globe injury emergency medical services activations

PURPOSE

To determine predictors of high pain in open globe injury (OGI) cases treated and transported by Emergency Medical Services.

METHODS

The National Emergency Medical Services Information System database was queried for activations of OGI between 2017 and 2021. Demographic, location, medication, and date and time information was collected. Cases were divided based on the intensity of maximum pain reported (low pain: below 5/10, high pain: above 5/10). Logistic regression was used to identify significant predictors of high maximum pain.

RESULTS

Of 53,589 cases of OGI, 20,766 reported high levels of pain. Females were more likely to report high pain than males (OR 1.24, CI 1.195-1.285). All age groups between 16 and 75 years old were more likely to report high pain than patients below 15, while all age groups above 75 were less likely. American Indians/Alaska Natives, Black, and Hispanic Americans were all more likely to report high pain than White Americans (American Indian, OR 1.249, CI 1.067-1.461; Black, OR 1.332, CI 1.277-1.390; Hispanic, OR 1.133, CI 1.064-1.207). OGI cases in the Midwest and South regions were less likely to report high pain than those in the West (Midwest, OR 0.868, CI 0.807-0.933; South, OR 0.800, CI 0.748-0.855). Compared to low pain patients, a greater percentage of high pain patients received opioid analgesia (10.04% vs. 0.44%).

CONCLUSIONS

Demographic factors and location may contribute to higher pain in OGI patients. This information may prove useful in the management of OGI and may warrant further investigation into the nature of open globe trauma.Kindly check and confirm the inserted city is correct for affiliation 3.Correct.

Global, regional, and national burden of esophageal cancer using the 2019 global burden of disease study

Esophageal cancer, with its aggressive nature and high mortality, poses diverse epidemiological challenges worldwide. Over the past three decades, esophageal cancer has exhibited a substantial global burden, marked by a significant increase in absolute numbers, contrasting with a decline in age-standardized metrics. Prevalence nearly doubled, reaching 0.961 million in 2019, while the age-standardized rate (ASR) decreased to 11.6 per 100,000 cases. New incidence cases surged by 67.07%, yet the age-standardized incidence rate reduced to 6.5 per 100,000 cases. Deaths increased to 0.498 million, with a decline in age-standardized mortality to 6.1 per 100,000 cases. Disability-Adjusted Life Years (DALYs) rose to 11.67 million, but the ASR decreased to 139.8 per 100,000 cases. Gender-specific analysis revealed consistently higher rates in males, with increasing gaps over time. Correlations with SDI indicated a negative association, and frontier analysis underscored the impact of socio-economic progress on disease control. Projections suggest a continued rise in prevalence, incidence, deaths, and DALYs, with gender-specific variations. The research underscores the importance of continued efforts in public health and medical research to adapt to and manage the changing landscape of esophageal cancer globally.

Analysis and prediction of subarachnoid hemorrhage burden in global, China, and Japan

BACKGROUND

Subarachnoid hemorrhage (SAH) remains a serious public health problem worldwide, especially in economically developed regions/countries. This study intends to thoroughly analyze the incidence, mortality, and disability-adjusted life years (DALYs) rate of SAH at the global, regional, and national levels. This study focused on the differences in SAH incidence between China and Japan from 1990 to 2019, and projected global, Chinese, and Japanese SAH incidence rates until 2030.

METHODS

Data on the disease burden owing to SAH from 1990 to 2019 were obtained from the Global Burden of Disease (GBD) Study 2019. linear regression analysis was used to calculate the estimated annual percentage change (EAPC) and linear regression method was used to calculate the average annual percentage change (AAPC). Bayesian age-period-cohort (BAPC) model was used to predict the disease burden from 2020 to 2030.

RESULTS

Globally, age-standardised incidence, mortality, and DALYs rates was declined from 1990 to 2019. In 1990-2019, the incidence of SAH decreased in China, while it increased in Japan, especially among middle-aged and elderly women. Projections suggest that the global incidence of SAH will decrease by 2.06% in 2030, with an increase of 6.24% in China and 13.82% in Japan, with the highest increase among Japanese women being 16.19%.

CONCLUSIONS

Global SAH incidence, mortality, and DALYs rates declined over the 1990-2019 period, with regional/national SAH mortality and DALYs rates negatively correlated with socio-demographic index (SDI), while SAH incidence was positively correlated with SDI. The incidence of SAH decreased in China and increased in Japan during this period. The predictions show that over the next 10 years, while the incidence of SAH continues to decline globally, the incidence of SAH in China and Japan has increased. Thus, SAH remains a serious disease burden that requires early intervention targeting risk factors and populations at risk that may have increased because of economic development.

Organic Foreign Body in the Eye, a Diagnostic Challenge: A Case of a Wooden, Intra-orbital Foreign Body Presenting at the Emergency Department

Intra-orbital organic foreign body injuries occur within the eye but without the involvement of the orbit itself. A 39-year-old man self-presented to the emergency department complaining of sudden onset of pain surrounding his left eye and of reduced vision. The initial examination was unremarkable except for two healing lesion marks above his left upper eyelid. Some swelling with erythematous skin changes was also noted. Computer tomography did not identify a conclusive cause. The patient was assessed by an Ophthalmologist in Eye Casualty and commenced intravenous antibiotics for infection secondary to an intra-orbital wooden foreign body. The patient underwent surgery to remove the foreign body, experienced no postoperative complications, and was discharged following a brief medical admission for intravenous antibiotic administration, with vision returning to normal in the affected eye. This case report showcases the difficulty of such cases, given the organic nature of the foreign body. It also highlights the need for high clinical suspicion with thorough history-taking, as well as physician collaboration, to ensure organic foreign bodies are considered in similar presentations or cases.

Global, regional, and national burden of preterm birth, 1990-2021: a systematic analysis from the global burden of disease study 2021

Background

Preterm birth and its complications are leading causes of mortality among children under five years of age. Given the increasing burden of preterm birth on neonatal mortality and long-term health outcomes worldwide, a comprehensive global analysis is essential to guide effective public health interventions and policies. This study aims to assess the burden of preterm birth at the global, regional, and national levels.

Methods

Using data from the Global Burden of Disease (GBD) 2021 database, this study analysed trends in age-standardized incidence rates (ASIR), age-standardized mortality rates (ASMR), and disability-adjusted life-years (DALYs) as primary outcomes for preterm birth from 1990 to 2021 at global, regional, and national levels. Data were assessed using joinpoint regression analysis, decomposition analysis, and the health inequality concentration index.

Findings

Globally, the incidence, mortality and DALYs due to preterm birth have shown a declining trend, but ASIR started to increase in 2016. Males were more commonly born preterm than females (12329075.82, 95% uncertainty interval [UI]: 12192632.55-12464605.4 vs. 9224694.94, 95% UI: 9113876.1-9330107.89). Changes in DALYs were primarily due to epidemiological change (111.97%) and population (-21.59%). Low Socio-demographic Index (SDI) regions increased in annual incidence cases (43.1%, 95% UI: 40.17-46.09), while high SDI regions decreased in annual incidence cases (-9.6%, 95% UI: -11.45 to -7.79). The highest annual mortality and DALYs respectively occurred in sub-Saharan Africa (295490.66, 95% UI: 241762.78-353624.41) and South Asia (32760273.93, 95% UI: 27295547.76-39070225.69). Western sub-Saharan Africa showed the largest increase in annual incidence (98.95%, 95% UI: 94.77 to 103.09), and Australasia had the lowest annual mortality (287.18, 95% UI: 244.26-339.42) and DALYs (61081.4, 95% UI: 50897.33-73069.96). Western sub-Saharan Africa also had the highest ASMR (21.57, 95% confidence interval [CI]: 17.9-25.89). The highest ASIR (543.78, 95% CI: 535.11-553.21) and age-standardized DALYs (2064.65, 95% CI: 1717.27-2473.36) both occurred in South Asia, while the lowest ASIR and age-standardized DALYs were seen in East Asia (147.31, 95% CI: 144.22-150.85) and High-income Asia Pacific (143.32, 95% CI: 117.9-167.25). India, Nigeria, and Pakistan ranked highest globally in terms of annual incidence cases, mortality, and DALYs, while the lowest annual incidence, mortality and DALYs respectively occurred in Tokelau (2.34, 95% UI: 2.12-2.56), San Marino (0.04, 95% UI: 0.02-0.07) and Tokelau (17.22, 95% UI: 11.11-24.95).

Interpretation

While the global burden of preterm birth has decreased, significant disparities persist, especially in low SDI regions. There is a need for more refined policies and preventive measures to effectively address preterm birth.

Funding

No funds, grants, or other support was received.

Ocular injuries among patients with major trauma in England and Wales from 2004 to 2021

BACKGROUND

Ocular trauma is a significant cause of blindness and is often missed in polytrauma. No contemporary studies report eye injuries in the setting of severe trauma in the UK. We investigated ocular injury epidemiology and trends among patients suffering major trauma in England and Wales from 2004 to 2021.

METHODS

We conducted a retrospective study utilising the Trauma Audit and Research Network (TARN) registry. Major trauma cases with concomitant eye injuries were included. Major trauma was defined as Injury Severity Score >15. Ocular injuries included globe, cranial nerve II, III, IV, and VI, and tear duct injuries. Orbital fractures and adnexal and lid injuries were not included. Demographics, injury profiles, and outcomes were extracted. We report descriptive statistics and 3-yearly trends.

RESULTS

Of 287 267 major trauma cases, 2368 (0.82%) had ocular injuries: prevalence decreased from 1.87% to 0.66% over the 2004-2021 period (P < 0.0001). Males comprised 72.2% of ocular injury cases, median age was 34.5 years. The proportion of ocular injuries from road traffic collisions fell from 43.1% to 25.3% while fall-related injuries increased and predominated (37.6% in 2019/21). Concomitant head injury occurred in 86.6%. The most common site of ocular injury was the conjunctiva (29.3%). Compared to previous TARN data (1989-2004), retinal injuries were threefold more prevalent (5.9% vs 18.5%), while corneal injuries were less (31.0% vs 6.6%).

CONCLUSIONS

Whilst identifying eye injuries in major trauma is challenging, it appears ocular injury epidemiology in this setting has shifted, though overall prevalence is low. These findings may inform prevention strategies, guideline development and resource allocation.

Factors affecting ocular trauma in Iran: A systematic review study

Background and Aims

Ocular trauma (OT) is a a major cause of ocular morbidity and blindness. This study was systematically conducted to determine the factors contributing to OT in Iran.

Methods

In this study, a systematic review of all published articles in Persian and English languages from 2000 to 2023 was conducted to investigate the factors affecting OT in Iran. The included studies encompassed cross-sectional, cohort, and case-control designs. Articles were selected from internationally recognized databases, including PubMed, Web of Science, Scopus, and Google Scholar, as well as Persian databases such as SID and Magiran. The search strategy involved using keywords aligned with the (MeSH) terms, such as "oculars," "trauma," and "Iran." Initially, 403 articles were identified, and ultimately, 14 articles met the inclusion criteria. To ensure the prevention of bias and assess the quality of the selected articles, the Newcastle-Ottawa Scale was utilized.

Result

In the present study, the majority of individuals in the reviewed articles were categorized as having mild eye injuries (13.8%). A higher percentage of injuries was observed in males compared to females, and a higher prevalence of injuries was also observed in the age group of over 30 years compared to other age groups. Among the mechanical causes, sharp trauma had the highest prevalence rate (72.5%), while falls had the lowest prevalence rate (14%), followed by sport-related injuries (29%). Non-mechanical injuries were mentioned in only one article and had a prevalence rate of 1.5.

Conclusion

The results of the current research have shown that among the mechanical injuries, accidents involving motorcycles and sharp objects are the leading causes of OT in Iranians. Therefore, the use of protective equipment such as goggles and adherence to traffic laws play a particularly important role, especially in men higher the age of 30. These findings highlight the necessity for targeted educational and preventive measures to reduce OT in Iran.

Prevalence, Characteristics, and Management of Pediatric Ocular Trauma in Riyadh, Saudi Arabia: A Retrospective Analysis

PURPOSE

Ocular trauma is a major cause of visual impairment; however, little is known about its burden in Saudi Arabia. Therefore, this study aimed to determine the epidemiological characteristics of ocular trauma in pediatric patients in Riyadh, Saudi Arabia.

PATIENTS AND METHODS

Medical records of pediatric patients diagnosed with eye injuries between January 2016 and December 2020 were retrospectively reviewed. Demographic and injury characteristics were collected, and ocular trauma injuries were classified according to the Birmingham Eye Trauma Terminology.

RESULTS

A total of 855 injured patients were included in the study, of whom 525 (61.4%) were boys. Patient age ranged from one month to 18 years. Most ocular injuries occurred in children aged 5-9 years. The injuries were more prevalent in boys than in girls. Closed globe injuries accounted for 70% of cases, open globe injuries for 21%, and other injuries for 9%. Most ocular injuries occurred at home (n = 87, 42%), followed by school (n = 61, 30%).

CONCLUSIONS

These results may inform the implementation and targeting of interventions to reduce or prevent eye injuries in children. Further, they highlight the importance of well-planned prevention programs to prevent eye injuries from occurring in children's daily lives.

Pattern of eye trauma among pediatric ophthalmic patients in upper and lower Egypt: A prospective two-center medicolegal study

Background

Ocular trauma is the leading cause of monocular blindness in children. This study aimed to identify and compare pediatric ocular injuries at two national university hospitals: Benha University Hospital (BUH) and South Valley University Hospital (SVUH) while evaluating the predictive utility of the Ocular Trauma Score (OTS) for post-traumatic permanent visual infirmity.

Design and methods

This multicenter observational study enrolled children under 18 years at BUH and SVUH Ophthalmology Departments from May 31 to December 31, 2022. Comprehensive medical histories and detailed data on eye trauma were obtained, with each undergoing thorough eye examinations at the initial presentation and during the 6-month follow-up period. The final visual outcome was permanent visual infirmity that was defined as the Best Corrected Visual Acuity in the better eye worse than 3/60 or near vision worse than N6 according to the International Classification of Diseases 11.

Results

The study included 120 cases evenly distributed between the two hospitals, with a mean age of 10.03 (±3.30) years, 74.17% male and 51.67% urban residents. Blunt, sharp, and foreign objects were the most common causes (39.17%, 33.33%, and 11.67%, respectively). Closed-globe injuries prevailed at BUH (83.33%) than SVUH (40.0%). Most injuries were accidental and outdoors, with an average interval of 9.93 (±23.57) hours to seek medical care. Lack of education, open-globe injuries, poor initial visual acuity, longer intervals from admission to intervention, and lower OTS were associated with visual impairment.

Disability-Adjusted Life Years Resulting from Ocular Injury among Deployed Service Members, 2001-2020

PURPOSE

To quantify the burden of ocular injuries on deployed US service members by calculating disability-adjusted life years (DALYs).

DESIGN

Retrospective, observational cohort study.

PARTICIPANTS

US service members with ocular injuries sustained in combat zones from January 1, 2001 to May 19, 2020.

METHODS

Health states and duration of injuries were identified using data from the Defense and Veterans Eye Injury and Vision Registry. These health states were mapped to disability weights from the Global Burden of Disease (GBD) study. Average duration of injury or illness was calculated until remission or death. For the latter, life expectancy at age of sustaining injury, as identified from US Life Tables from the National Vital Statistics Reports 2020, was used. Using Defense Manpower Data Center reports capturing number of service members deployed per year, incidence rates were calculated for ocular injury and DALYs.

MAIN OUTCOME MEASURES

Disability-adjusted life years of ocular injury.

RESULTS

Seventeen thousand five hundred fifty-five patients sustained ocular injury that incurred DALYs. In total, these injuries resulted in 11 214 DALYs (average, 0.64 DALYs per included patient and 20.6 DALYs per 10 000 US service members per year). Severe impairment of distance vision (77.9%) and blindness (10.6%) were the primary contributors of DALYs. Although only 9.3% of patients sustained a permanent ocular injury, permanent disability accounted for 99.5% of total DALYs. The average yearly incidence rate of ocular injury was 32.0 cases per 10 000 US service members. Foreign body was the most frequent injury type (2754 occurrences), followed by abrasion (2419 occurrences) and multiple injury types (1429 occurrences). The most DALYs occurred in patients with multiple injury types (2485 DALYs), followed by abrasion (accounting for 725 DALYs) and foreign body (accounting for 461 DALYs).

DISCUSSION

We report higher average DALYs per case ratio among US service members compared with the general population studied by the GBD study, highlighting the differences in probabilities of permanent injury between the two studies. Our study provides understanding of the impact of ocular injuries on active-duty service members and lays the groundwork for further research and interventions to mitigate their burden.

FINANCIAL DISCLOSURE(S)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Cross-country health inequalities of four common nutritional deficiencies among children, 1990 to 2019: data from the Global Burden of Disease Study 2019

BACKGROUND

Nutritional deficiencies remain serious medical and public health issues worldwide, especially in children. This study aims to analyze cross-country inequality in four common nutritional deficiencies (protein-energy malnutrition, dietary iron deficiency, vitamin A deficiency and iodine deficiency) among children from 1990 to 2019 based on Global Burden of Disease (GBD) 2019 data.

METHODS

Prevalence and disability-adjusted life years (DALYs) data as measures of four nutritional deficiency burdens in people aged 0 to 14 years were extracted from the GBD Results Tool. We analyzed temporal trends in prevalence by calculating the average annual percent change (AAPC) and quantified cross-country inequalities in disease burden using the slope index.

RESULTS

Globally, the age-standardized prevalence rates of dietary iron deficiency, vitamin A deficiency and iodine deficiency decreased, with AAPCs of -0.14 (-0.15 to -0.12), -2.77 (-2.96 to -2.58), and -2.17 (-2.3 to -2.03) from 1999 to 2019, respectively. Significant reductions in socio-demographic index (SDI)-related inequality occurred in protein-energy malnutrition and vitamin A deficiency, while the health inequality for dietary iron deficiency and iodine deficiency remained basically unchanged. The age-standardized prevalence and DALY rates of the four nutritional deficiencies decreased as the SDI and healthcare access and quality index increased.

CONCLUSIONS

The global burden of nutritional deficiency has decreased since 1990, but cross-country health inequalities still exist. More efficient public health measures are needed to reduce disease burdens, particularly in low-SDI countries/territories.

Ocular injuries sustained at home in five metropolitan cities: a review of 5008 cases

Background

In Iran, ocular injuries sustained at home are a growing public health issue, and few studies have explored their prevalence and the frequencies of different causes of these injuries. We investigated the features of ocular injuries at home among children and adolescents (aged < 18 years), adults (18 - 64 years), and the elderly ( ≥ 65 years) in five metropolitan cities.

Methods

In this cross-sectional study, we recruited individuals with ocular injuries sustained at home who presented to 12 public/teaching hospitals in five metropolitan cities during a 5-month period. Using clinical records within the emergency department archives, we collected the following data: age, sex, frequency of injuries requiring hospital admission or surgical intervention, and causes of eye injuries, documented as 1) cleaning products, 2) chemical products, 3) kitchen items, 4) cooking activities, 5) toys, 6) falls from height, 7) sports equipment, 8) penetrating or cutting, 9) abrasions, 10) foreign bodies, and 11) direct blows by other individuals.

Results

Of 5008 participants from the five cities, 74% (n = 3711) were male and 26% (n = 1297) were female. The most frequent causes of injury among children and adolescents, adults, and the elderly were toys, kitchen items, and cooking activities, respectively. In children and adolescents, injuries were caused by kitchen items, toys, foreign bodies, and direct blows by other individuals more frequently than in adults or the elderly, and by cleaning products and abrasions more frequently than in the elderly (all P < 0.05). In adults, injuries were caused by cleaning products, cooking activities, falls from height, sports equipment, penetrating or cutting, and abrasions more frequently than in children and adolescents or the elderly (all P < 0.05), and by kitchen items, toys, and blows by other individuals more frequently than in the elderly (all P < 0.05). In the elderly, injuries were caused by chemical products more frequently than in children and adolescents or adults, and by cooking activities, falls from height, and sports equipment more frequently than in children and adolescents (all P < 0.05). In adults, the frequency of ocular injuries was significantly higher in Tehran and lower in Mashhad when comparing each with that of the other four cities (all P < 0.05). We found a significantly higher frequency of ocular injuries by cleaning and chemical products in Tehran, by toys in Shiraz, by falls from height in Isfahan, and by direct blows by other individuals in Ahvaz when comparing each to that of the other four cities (all P < 0.05). Regarding the prevalence of severe ocular injuries among the children/adolescent and adult age groups, conditions were relatively better in Shiraz and relatively unfavorable in Mashhad.

Conclusions

Ocular trauma was more common in male individuals and the younger age groups. Approximately half of the causes were kitchen items, toys, and foreign bodies, which are avoidable by enhancing public eye health awareness. The prevalence of severe ocular injuries in individuals aged < 18 years was high, highlighting the necessity of nationwide preventive strategies for pediatric ocular injuries.