Demographics and Clinical Characteristics of Open- Globe Ocular Trauma at a Tertiary Eye Center in the Philippines: A 5-Year Retrospective Review

Objective: To describe the demographics and clinical characteristics associated with visual acuity (VA) in open-globe trauma patients at a tertiary eye center in the Philippines.

Design and Methods: A retrospective cohort study of 445 patient records from January 2013 to November 2017 was done. All openglobe injuries, defined by Birmingham Eye Trauma Terminology classification system, were included [1]. Data about demographics and clinical characteristics were collected. Baseline VA was compared to last follow-up VA, classified as excellent (>20/60), good (20/80 to 20/200) or poor (<20/200).

Results: The mean age of patients was 28.0±16.9 years. The most common objects causing injury were hammered nails at work (57/232 [24.6%]) while for children 8 years and younger they were knives at home (7/34 [20.6%]). The most common complication was intraocular foreign body (IOFB) (27/107 [25.2%]). Subgroup analysis was done on patients with at least 1-month follow-up, with mean follow-up time of 105.5±259 days. At final consult 59.6% (84/141) had excellent outcome, 12.8% (18/141) had good outcome, and 27.7% (39/141) had poor outcome. For complications, VA improved significantly between initial and last consult for eyes with vitreous hemorrhage (LogMAR 1.87±0.83 vs 1.40±1.00; p=0.022), IOFB (LogMAR 1.69±0.91 vs 1.10±0.98; p=0.011) and eyes needing penetrating keratoplasty (LogMAR 2.07±0.68 vs 1.22±0.94; p=0.007). There was no significant improvement in VA for eyes presenting with retinal detachment and endophthalmitis. Better initial VA correlated with excellent final VA (p<0.006, OR=1.131, 95% CI=0.331, 1.930).

Conclusion: Ocular trauma continues to be a common cause of preventable blindness in the Philippines, most commonly seen at the workplace. Prognosis and management of patients should be based on initial VA, and other pertinent clinical characteristics.

Keywords: Open globe; Trauma; Public health; Birmingham eye trauma classification system; BETT; Visual outcomes