Ophthalmic Trauma: An Overlooked Global Cause of Preventable Blindness and Disability

Purpose Ophthalmic trauma is a substantial yet overlooked public health challenge, pertinent across all age groups, geographies, and socioeconomic statuses. Despite being largely preventable, it constitutes a major cause of monocular vision loss and long-term disability-adjusted life years among ophthalmic conditions, with a disproportionately high burden in low- and middle-income countries. Integrating original data from the International Globe and Adnexal Trauma Epidemiology Study (IGATES) registry, this hybrid perspective provides an overview of the global burden of ophthalmic trauma and emphasizes the urgent need for coordinated public health strategies focused on prevention and intervention.

Design Perspective and multinational retrospective descriptive cohort study using registry-based real-world data.

Participants 8238 patients with clinical evidence of ophthalmic trauma from 32 tertiary centers across 12 countries.

Methods Data from 8238 patients with clinical evidence of ophthalmic trauma within the IGATES registry was analyzed, and descriptive statistics were utilized to characterize patient demographics, injury patterns, timing of presentation, and visual outcomes.

Main Outcome Measures Primary outcomes included type and setting of trauma, duration to presentation, presence of eye protection, and best-corrected visual acuity (BCVA) at final follow-up.

Results In this 8238-patient cohort, 78.5% were male and the mean age was 31.4 years. Closed globe injuries accounted for 56.9% of cases, while open globe injuries comprised 34.0% of cases. 70.0% of patients presented more than 12 hours after injury. 30.0% had a final BCVA of worse than 6/60 and 7.0% had no light perception. More eye injuries occurred at home than elsewhere at 38.2%, followed by the workplace at 19.4%, and road traffic accidents at 8.8%. Eye protection was not worn in almost all cases at 99.0%.

Conclusion This perspective calls for a shift in framing, for ophthalmic trauma not to be treated as an isolated clinical issue but prioritized as a preventable public health concern. Opportunities, from strengthened legislation and enforcement to heightened community awareness and system-level preparedness, are further outlined to reduce the burden of ophthalmic trauma and enhance care.