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lüll The epidemiology and diagnosis of penetrating eye injuries Smith D; Wrenn K; Stack LBAcad Emerg Med 2002[Mar]; 9 (3): 209-13It is estimated that there are 3.1 penetrating eye injuries per 100,000 person-years in the United States. OBJECTIVES: To evaluate the epidemiology of penetrating eye injuries and to identify physical examination findings that facilitate the diagnosis and ophthalmologic referral of patients with these injuries. METHODS: This was a retrospective chart review of emergency department patients with penetrating eye injuries seen for evaluation from July 1987 to January 1999. The setting was a tertiary referral, university hospital. Three hundred eighty-four patients with 390 penetrating eye injuries were enrolled; 56% were transferred from outlying hospitals. RESULTS: Penetrating eye injuries were seen almost three times per month. Eighty percent of the injuries occurred in males, and the mean age was 29 years. Twenty-five percent of the patients had used alcohol in the period immediately preceding the injury. Final visual outcome was 28% with enucleation, "no light perception" (NLP) in 10%, light perception to 20/200 in 24%, and light perception of 20/200 or better in 38%. Poor visual outcome was associated with poor initial visual acuity, alcohol use, and delayed presentation (p = 0.036, 0.025, 0.036, respectively). Gun-related injuries caused 33% and motor vehicle crashes (MVCs) caused 21% of the worst outcomes (enucleation or NLP). In MVCs where seat belt use was reported, 71% of injured patients were unrestrained. The most common initial physical findings were hyphema (76%), abnormality of the pupil or uvea (94%), and initial visual acuity worse than 20/200 (77%). All patients had at least one of these findings. Complications occurred in 25% of cases, most commonly traumatic cataract or infection. Complications occurred more commonly in those patients transferred than in those presenting directly (p = 0.002). CONCLUSIONS: Penetrating eye injuries are relatively common, occur predominantly in young males, and often result in poor visual outcome in the affected eye. Motor vehicle crashes, alcohol use, and fire-arm use are associated with more severe injuries.|Accidents, Traffic/statistics & numerical data[MESH]|Adolescent[MESH]|Adult[MESH]|Age Distribution[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Alabama/epidemiology[MESH]|Child[MESH]|Child, Preschool[MESH]|Emergency Service, Hospital/*statistics & numerical data[MESH]|Eye Enucleation/statistics & numerical data[MESH]|Eye Injuries, Penetrating/diagnosis/*epidemiology[MESH]|Female[MESH]|Humans[MESH]|Infant[MESH]|Kentucky/epidemiology[MESH]|Male[MESH]|Middle Aged[MESH]|Prevalence[MESH]|Prognosis[MESH]|Retrospective Studies[MESH]|Sex Distribution[MESH]|Tennessee/epidemiology[MESH]|Visual Acuity[MESH]|Wounds, Gunshot/epidemiology[MESH] |