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Khan MMH, Akhlaq A, Khan MJ, Ali M, Joseph E, Justin GA, Woreta F. Impact of social determinants of health on causes of ophthalmic trauma: A narrative review. Surv Ophthalmol 2025:S0039-6257(25)00091-8. [PMID: 40419165 DOI: 10.1016/j.survophthal.2025.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2024] [Revised: 05/13/2025] [Accepted: 05/19/2025] [Indexed: 05/28/2025]
Abstract
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.
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Affiliation(s)
| | - Anam Akhlaq
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Muhammad Jehanzeb Khan
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Muhammad Ali
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Emily Joseph
- Informationist Services, Welch Medical Library, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Grant A Justin
- Department of Ophthalmology, Walter Reed National Medical Center, 8901 Rockville Pike, Bethesda, MD 20889, USA.
| | - Fasika Woreta
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
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Choudhry HS, Kuklinski EJ, Fu A, Shukla P, Montani M, Eraky F, Zarbin MA, Langer PD, Bhagat N. Bibliometric analysis of published works in ocular trauma: a growing focus on open globe injury. Int Ophthalmol 2025; 45:47. [PMID: 39881069 DOI: 10.1007/s10792-025-03417-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Accepted: 01/19/2025] [Indexed: 01/31/2025]
Abstract
PURPOSE The purpose of this study is to analyze the trends and characteristics of ocular trauma research published from 2000 to 2022 to delineate the trajectory of the field's research, provide information about the network of key contributors, and help determine future research strategies and direction. METHODS Web of Science was queried for published works using a series of keywords relating to ocular trauma: "globe rupture", "ruptured globe", "globe injury", "ocular trauma", "intraocular foreign body", "eye trauma", "eye injury", and "traumatic endophthalmitis". All article information was compiled using the VOSviewer software. Article information analyzed included year of publication, publishing journal, author, institution, country, and keywords/key terms. RESULTS A total of 3362 articles were identified. In the time period studied, there is a noticeable trend for an increase in the number of papers pertaining to ocular trauma to be published annually. The journal, Eye published the most, and the United States produced the most articles of any country. Important keywords other than "ocular trauma" included "epidemiology", "management", "children", "vitrectomy" and "endophthalmitis". CONCLUSION Complications due to ocular trauma are seen worldwide. Many different institutions, journals, and countries have published research on ocular trauma with an increased frequency in recent years. This study provides valuable information on the status of scholarly investigation of ocular trauma in the last 2 decades and sheds light on the trajectory of recent research interest.
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Affiliation(s)
| | | | - Allen Fu
- Department of Cell Biology and Neuroscience, Rutgers University, New Brunswick, NJ, USA
| | - Param Shukla
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | | | | | - Marco A Zarbin
- Department of Ophthalmology, Rutgers New Jersey Medical School, Institute of Ophthalmology and Visual Science, Newark, NJ, USA
| | - Paul D Langer
- Department of Ophthalmology, Rutgers New Jersey Medical School, Institute of Ophthalmology and Visual Science, Newark, NJ, USA
| | - Neelakshi Bhagat
- Department of Ophthalmology, Rutgers New Jersey Medical School, Institute of Ophthalmology and Visual Science, Newark, NJ, USA.
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Dewhurst N, Tangri D, Arslan J, Ashraf G, Chakrabarti R, Crock C. Ocular trauma in badminton: A 5-year review of badminton-related eye injury emergency department presentations. Emerg Med Australas 2024; 36:915-919. [PMID: 39091274 DOI: 10.1111/1742-6723.14473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/09/2024] [Accepted: 07/15/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVE To examine the nature and severity of badminton-related ocular injuries in Melbourne, Australia. METHODS This is a retrospective chart review. A search of the medical records was conducted for patients presenting to the ED at The Royal Victorian Eye and Ear Hospital, with badminton-related eye injuries from June 2018 to May 2023. Data were extracted, focusing on injury mechanism, patient demographics and treatment outcomes. RESULTS In total, 88 patients were included in the study, comprising 64 (73%) men and 24 (27%) women. The mean patient age was 36.13 years. The most common injury was hyphaema (73%), followed by commotio retinae (45%). One patient sustained a penetrating eye injury when a shuttlecock shattered the spectacles he was wearing during play. Medical intervention was required for 90% of patients. The most common interventions were steroid eye drops (80%) and cycloplegic eyedrops (76%). A total of six (7%) patients required surgical management. For those 69 patients followed up at The Royal Victorian Eye and Ear Hospital, 77% of patients had a final best-corrected visual acuity of 6/6 or greater. CONCLUSIONS Hyphaema, commotio retinae and traumatic uveitis were the most commonly diagnosed injuries. The majority of patients with badminton-related eye injuries required medical treatment, and some necessitated surgical intervention. To mitigate these risks, there is a pressing need to develop an eye safety policy for Australian badminton players, and players should exercise caution when wearing spectacles during play to prevent potential penetrating eye injuries.
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Affiliation(s)
- Nicholas Dewhurst
- Emergency Department, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Department of Nuclear Medicine, PET and Ultrasound, Westmead Hospital, Westmead, New South Wales, Australia
| | - Devangna Tangri
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Janan Arslan
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Gizem Ashraf
- Emergency Department, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Rahul Chakrabarti
- Emergency Department, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Department of Neuro-Ophthalmology, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Carmel Crock
- Emergency Department, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
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Yang Y, Chen J, Hu J, Shen H, Chen Q, Huang H, Zheng Y, Zhong L. Ocular trauma from Lawn mower accidents: Clinical insights, visual outcomes and microbial profiles. Am J Emerg Med 2024; 80:18-23. [PMID: 38479112 DOI: 10.1016/j.ajem.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/11/2024] [Indexed: 05/31/2024] Open
Abstract
AIMS To characterize the clinical features of ocular trauma resulting from lawn mower, identify determinants of unfavorable final visual acuity (FVA), and assess the spectrum of microbial in posttraumatic endophthalmitis. METHODS This retrospective study enrolled patients who experienced ocular trauma due to lawn mower at Zhongshan Ophthalmic Center from January 2013 to August 2021. Demographics, clinical features, isolated microorganisms, risk factors influencing reduced visual acuity, treatment regimens, and utilization of eyewear were collected. RESULTS The study included 140 participants (140 eyes) (49.47 ± 12.03 years, 95% male). The predominant injury manifestations were penetrating globe injuries (75.7%) and intraocular foreign bodies (51.4%). Endophthalmitis occurred in 35 cases (25%) and Bacillus cereus (23.5%) was the primary pathogen, followed by Staphylococcus epidermidis (11.8%) and Streptococcus species (11.8%). Following the initial assessment, where 77.9% of patients had initial visual acuity (IVA) at grade IV (ranging from light perception to 4/200) and only 0.7% attained grade I (better than 20/40), post-treatment results revealed that 5.7% achieved FVA at grade I, with a concurrent decrease in patients with grade IV vision to 64.3%. Multivariate logistic regression revealed that injury protection (p < 0.001, OR = 0.237, 95% CI = 0.126-0.446), IVA (p = 0.001, OR = 4.102, 95% CI = 1.730-9.729), and retinal detachment (p = 0.042, OR = 8.105, 95% CI = 1.075-61.111) were significant independent risk factors impacting FVA. CONCLUSION Lawn mower often cause severe ocular injuries, with high-velocity metal foreign bodies that can lead to infections, most commonly caused by Bacillus cereus. Correct use of protective gear, initial vision assessment, and detecting retinal detachment are crucial for visual prognosis.
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Affiliation(s)
- Yan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Juan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Jingyi Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Hongyi Shen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Qiuying Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Hailu Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yongxin Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China.
| | - Liuxueying Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China.
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Mazarelo JFD, Winter SL, Fong DTP. A Systematic Review on the Effectiveness of Eyewear in Reducing the Incidence and Severity of Eye Injuries in Racket Sports. PHYSICIAN SPORTSMED 2024; 52:115-124. [PMID: 37070274 DOI: 10.1080/00913847.2023.2196934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/27/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE To assess what eyewear (if any) reduces eye injury incidence and severity in squash, racketball, tennis and badminton. DESIGN Systematic review following the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' (PRISMA) and the 'implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science' (PERSiST) guidelines. METHODS PubMed, SportDiscus and Web of Science were searched on 22nd February 2023. All study types except reviews were eligible. Studies had to report the type of eyewear worn (if any) with a form of eye injury incidence and severity. RESULTS 364 papers were initially retrieved and after the screening process 29 remained. A subgroup analysis was carried out on studies that had a sample size of five or above, were not only looking at a particular type of eye injury and that had sufficient data to allow the percentage of eye injuries that occurred when no eyewear was worn to be calculated. From this analysis, the median percentage of eye injuries that occurred when no eyewear was worn was found to be 93%. Some of these injuries were serious and required complex treatment. Prescription lenses, contact lenses and industrial eyewear made some injuries more severe. In squash and racketball, lensless eye guards were ineffective as the ball could deform on impact, still making contact with the eye. Only eyewear compliant with updated ASTM (or similar) standards was associated with no eye injuries and so provided adequate protection in all four sports. CONCLUSIONS Although this systematic review only summarizes evidence on injuries requiring hospital treatment, it is recommended that national governing bodies and key decision makers within squash, racketball, tennis and badminton examine the evidence presented and consider extending existing rules or implementing new recommendations and policies on protective eyewear use to reduce eye injury incidence and severity in their sport.
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Affiliation(s)
- James F D Mazarelo
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Samantha L Winter
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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