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Abstract
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Worldwide, eye trauma is a significant burden and the leading cause of monocular blindness. An estimated 3.15 per 1000 population eye injuries are treated every year in emergency departments throughout the United States. Additionally, nearly one third of patients with serious eye trauma do not regain vision to better than 20/200. Despite the availability of data on the incidence and causes of eye injury in the United States, a paucity of population-based data exists on visual outcomes and treatment methods. Furthermore, currently no active eye trauma registry exists that monitors the outcomes of eye trauma to guide management and policies.
In 1988, the American Society of Ocular Trauma created the United States Eye Injury Registry (USEIR), a nonprofit organization sponsored by the Helen Keller Eye Research Foundation. The USEIR collected data on serious eye trauma in 40 states from hospitals, emergency departments, and private ophthalmology offices. The data collected included clinical information from the initial visit to the conclusion of the clinical course. Information for the USEIR initially was collected on paper or floppy discs, and later evolved to an online form. Between 1988 and 2003, the USEIR collected data on 11 360 eye trauma cases. However, the registry became inactive in 2013, and since then, no other registry has collected comparable information on ophthalmic trauma.
The information from the USEIR served as a foundation for standardizing eye trauma terminology, was the basis for the development of methods to predict trauma outcomes, quantified crucial epidemiologic information, and provided evidence for policy recommendations. From the experience of collecting data with variable terminology for trauma, Kuhn et al developed a standardized classification for ocular trauma, the Birmingham Eye Trauma Terminology, that has been adapted for research as well as medical coding. The USEIR group also used their database to develop the Ocular Trauma Score, which predicts visual outcomes after open-globe injuries to counsel patients on expectations for visual recovery. This score is based on initial visual acuity and presence of globe rupture, endophthalmitis, perforating injury, retinal detachment, and relative afferent pupillary defect. In addition, the USEIR provided epidemiologic information for eye injuries and found that most eye injuries occurred in men and young adults. Another finding from this registry is that eye injuries that occur at jobs with mandated eye protection resulted in better visual outcomes, further supporting legislation for eye protection during work and sports. With regard to firework-related eye injuries, USEIR revealed that most such eye injuries were the result of bottle rockets. Thus, the USEIR has advocated for the ban of bottle rocket sales in conjunction with the American Academy of Ophthalmology and the American Academy of Pediatrics...
Language: en |