AUG 23, 2010
This retrospective chart review included 812 consecutive patients with open globe injuries treated at a single center between 1999 and 2008. From these, researchers indentified 146 patients with open globe injuries sustained at work and compared their characteristics and outcomes with the rest of the patients in the database.
Of the patients injured at work, 98 percent were men; average age, 35.8 years. Patients with occupational injuries were more likely to have penetrating injuries (P= 0.0005) and far less likely to have blunt ocular trauma (P = 0.0001). Of patients injured at work, 38 had intraocular foreign bodies, which was significantly greater than the proportion of patients in the control group (P = 0.0001). Visual acuity outcomes were better in the work-related group (P = 0.0001), with more than 74 percent of cases achieving a final visual acuity of better than 20/200. There was no difference in the enucleation rate (P = 0.4). There was also no significant difference in time between injury and initial presentation. However, 17 percent of workers took more than 12 hours to present for medical evaluation and 10 presented more than 24 hours after injury, placing them outside the ideal window of time for primary repair of ruptured globes. In addition, a number of patients injured at work developed endophthalmitis, which can be associated with delays in surgical repair.
The authors write that employers should use this information to strengthen and refine their safety policies. Further research is needed to better understand protective eyewear compliance difficulties and barriers to obtaining timely medical attention for injuries.