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Journal Article

Citation

Slentz DH, Joseph AW, Joseph SS. JAMA Ophthalmol. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, American Medical Association)

DOI

10.1001/jamaophthalmol.2021.1543

PMID

unavailable

Abstract

Intimate partner violence (IPV) refers to any behavior in a past or present intimate relationship that causes physical, psychological, or sexual harm. Prior to the COVID-19 pandemic, survey data from the US Centers for Disease Control and Prevention shows that 1 in 4 women and 1 in 10 men experience IPV in the United States.1 Approximately 30.6% of women experience IPV-related physical abuse, with 21.4% of these women experiencing severe physical injuries.1

The IPV public health crisis has since been exacerbated by the COVID-19 pandemic. In March 2020, law enforcement agencies observed an increase in domestic violence calls to US police departments by 27% in some regions after stay-at-home orders were implemented.2 The medical community has also observed a rise in the incidence and severity of IPV-related physical injuries, including head trauma, facial fractures, and visceral organ damage.3 The stay-at-home orders intended to curb the spread of COVID-19 may have inadvertently isolated many individuals who experience IPV with their abusers and/or triggered the development of new instances of violence. Individuals who experience IPV who were ready to leave abusive relationships may have suddenly found it difficult to access support networks, including lodging with family/friends and alternative shelters in the setting of travel restrictions and limited operating capacities. As a result, many of these individuals were left in potentially dangerous situations with limited options and resources.

Now more than ever, during the COVID-19 pandemic, strategies to effectively screen for and prevent IPV are needed. Ophthalmologists and oculofacial plastic surgeons can play a particularly vital role in this effort. The midface is the most commonly involved anatomical site of injury in IPV-related physical abuse, and women with physical injuries in the head, neck, and face are 7.5 times more likely to have experienced IPV compared with women with injuries elsewhere.4-6 IPV-related ocular injuries can be vision threatening and include intraocular hemorrhages, traumatic cataract, retinal detachment, and globe rupture.6 In addition, IPV-related physical injury is responsible for 7.6% to 10.2% of orbital and zygomaticomaxillary complex (ZMC) fractures in women,4,6,7 although the true prevalence is likely underestimated because the cause or perpetrator for many assault cases remain unidentified.1,5 ZMC fractures require a more severe mechanism of injury than orbital fractures, with substantial force and/or repeated trauma. Disturbingly, ZMC fractures occur twice as frequently in IPV-related assault compared with non-IPV-related violence.4,6 Thus, detection and prevention of IPV in patients with oculofacial injury is of paramount importance and could be vision saving and lifesaving...


Language: en

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