Epidemiology of Blinding Trauma in the United States Eye Injury Registry

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Abstract
To analyze the epidemiology and clinical characteristics of serious eye injuries leading to legal blindness. Analysis of information on 11,320 eyes in the United States Eye Injury Registry (USEIR) database. Legal blindness in this study was defined as visual acuity of worse than 20/200. No less than 27% of eyes with serious injury had < 20/200 final vision, although the rate varied greatly with injury type. Several risk factors were found to statistically significantly increase the chance of eye trauma resulting in blindness: age over 60 years, injury by assault, sustained on street/highway, or occurring during fall or by gunshot. Trauma to the left eye carried a statistically significantly poor prognosis as did two injury types, rupture and perforating. Involvement of the posterior segment was another factor indicating poor outcome; in particular, vitreous hemorrhage, retinal detachment, choroidal rupture, and endophthalmitis were found to increase the risk of blindness. Conversely, young age, contusion and intraocular foreign body injuries, among others, signaled a better than average chance of good outcome. Overall, 60.5% of injured eyes showed visual improvement after treatment. This large study identified multiple risk factors whose presence significantly increases the chance of the injured eye becoming "legally blind." Continued efforts to improve treatment and develop/implement prevention measures based on risk analysis should reduce the incidence of blinding trauma.

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