Firearm-related Eye Trauma Often Nonfatal, But With Severe Issues

Joyce N. Mbekeani, MD, FRCS

Cases of firearms-related eye trauma has been found to have significant disparities in patient race, incident location, and circumstance, according to a study presented at the 121st Annual Meeting of the American Academy of Ophthalmology (AAO 2017) in New Orleans, LA.

In a retrospective study of patients with firearms-related ocular trauma, researchers from the Albert Einstein College of Medicine in New York found the average US patient was a white male in his mid-30s, from the South.

The researchers, led by Joyce N. Mbekeani, MD, FRCS, a clinical associate professor at Albert Einstein, assessed data from the National Trauma Data Bank. The registry was assembled by the American College of Surgeons.

In gauging the 235,254 recorded firearm injuries from 2008 to 2014, researchers reported that 8,715 (3.7%) involved patients’ eyes.

Though survival rate for eye-related patients was 84% in that time period, 64.6% of patients suffered traumatic brain injuries.

Other commons injuries related to firearm-related eye trauma included orbital fractures (38.6%) and open globe injuries (34.7%). Adnexae contusions (15.7%) and open wounds (14%) were also commonly reported.

The average patient age was 33.8 years. Males made up 85.7% of the patient population, and whites were the most prominent patient race (46.6%). African Americans comprised 35% of the patient population.

The common locations of the firearm incidences that resulted in eye trauma were at homes (43.8%) and on streets (21.4%). African-American patients had greater odds of being involved in an incident on the streets, while white patients had greater odds of suffering self-inflicted trauma at home.

The study’s statistical analysis was performed with SPSS software, according to researchers.

Researchers projected hope that the data could help improve public policies, as firearm injuries are a “major burden to the healthcare system and a source of significant morbidity and mortality in the US,” they wrote.

Though the majority of cases were nonfatal, the reported injuries can be “debilitating, leaving patients in need of extensive rehabilitation,” Mbekeani said. The commonality of cases is an unfortunately well-known fact in public health .

“Firearms are a leading cause of sight-threatening ocular trauma and associated traumatic brain injury in the United States,” Mbekeani said.

Though the researchers were unable to give a definite explanation to the racial and ethnic disparities found in the study, Mbekeani said she believes the differences can be used to develop “demographically guided interventions that could help prevent unnecessary vision loss and long-term disabilities caused by firearms."