Ocular Trauma Trends in Indonesia: Poor Initial Uncorrected Visual Acuity Associated with Mechanism of Injury

Abstract

Objectives: To identify ocular trauma trends and to analyze how initial uncorrected visual acuity (VA) is associated with mechanism of injury (MOI) in a referral hospital in Indonesia. Methods: A five-year medical chart review at the Ophthalmology Emergency Department (OED) Dr. Soetomo General Academic Hospital (DSGAH). The information retrieved included sex, age, laterality involvement, initial uncorrected VA, MOI and management. Sex- and age- adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the relationship between poor initial uncorrected VA and MOI, using multivariate logistic regression analysis. Results: A total of 953 patients consisted of 80.3% males and 19.9% females. Ocular trauma predominantly occurred in 21–30 years age group (20.9%). May and November were found to have the highest average number of monthly patients. Closed globe injuries (80.3%) were more prevalent than open globe injuries (17.7%). The most frequent MOIs were sharp objects (311; 32.6%), followed by blunt objects (236; 24.8%). Most cases (89.2%) displayed unilateral involvement and 54.3% cases showed an initial uncorrected VA of better than 6/18. Compared to road dust, blunt object, sharp object and traffic accident were significantly associated with poor initial VA, with adjusted ORs (95% CIs) of 5.24 (2.27-12.10), 4.03 (1.76-9.25) and 8.17 (3.31-20.15), respectively. Conclusions: Initial uncorrected VA and MOI provide earlier information regarding the prognosis. Traffic accident showed a greater tendency to cause a poor initial uncorrected VA. Most ocular trauma is preventable by educating people at risk to avoid common MOIs and to use protection.