Mechanical injuries of the eye: incidence, structure and possibilities for prevention.

BACKGROUND/AIM Despite technological advances used in everyday clinical practice, injuries of the eye caused by various agents still produce blindness and poor vision in a significant number of people. The aim of this study was to analyze factors leading to occurrence of mechanical injuries of the eye. METHODS Mechanic injuries of the eye in patients treated at the Institute for Eye Diseases of the Clinical Center of Serbia in Belgrade, in an eight-year period were analyzed. Investigated parameters were: sex and age of patients, their profession, time of injury (months, days and hours), place and way of injury and a visual acuity on admission and dismiss, as well as further follow-up. Type of injury (closed or opened injuries of the eyeball), with all the complications that followed were carefully noted and monitored. The time of primary surgical repair was noted and analyzed, whenever necessary. RESULTS In the period of eight years, 2 701 patients (2 257 males and 444 females) were treated in the hospital due to mechanical injury of the eye. Almost equally, both the right (50.5%) and the left eye (49.5%) were injured, while in 39 (1.4%) patients both eyes were injured at the same time. The injuries occurred in all age groups, but mostly in adults, employed persons, aged from 16 to 65 (70%). Among injured children, 18.8% were beyond the age of 15. Most frequent injuries occurred in workers (39%), and then in pupils (16.3%). Wood was the mean of injury in 23.7% of cases, sharp and pointed objects in 16.1%, hammering and metal particles in 14.4%, glass in 10.1%, and other different objects in the rest of 35.7% of all injured persons. There were other very serious means or mechanisms of eye injuries, like hair band, dog bite, rooster's beak, rubber bullet, etc. Considering months in the year and days in the week, the injuries were almost equally distributed, and related to the time of day even 75% occurred between 10 a.m. and 10 p.m. Most injuries (38.2%) occurred while doing some work out of professional working place, while only 25.4% injuries occurred at the working place. Most of the patients (30.3%) had visual acuity L+P+ (light perception with correct projection) only, on attendance, but it varied from complete blindness to 1.0. There were 1 282 blunt injuries (contusion) (47.5%) and 1 373 penetrating eyeball injuries (50.8%), while the rest (1.7%) were injuries of ocular adnexa. Most of the primary surgical treatments (63.7%) were done in the first 24 hours from the moment of the injury. At dismiss, visual acuity was normal in 53.2%, the eye was blind in 19.1% injured patients. CONCLUSION The results of this study showed that the injuries occurred most frequently in actively working people and pupils, that men were injured five times more often than women; that wood, sharp objects and glass were the most common means, that there was an equal number of blunt injuries and penetrating wounds, and that it was very important to treat injury promptly, preferably within the first 24 hours. By further analysis, it might be concluded that many injuries could have been prevented, avoiding long medical treatment and accompanying costs, and what is most important--permanent invalidity caused by reduced visual function or blindness of the injured eye is avoidable.