The epidemiology of ocular trauma in Singapore: perspective from the emergency service of a large tertiary hospital.

PURPOSE: To describe the epidemiology of ocular trauma from the perspective of the emergency service of a large tertiary hospital in Singapore. METHODS: A prospective survey was conducted over a 3 month period (August to October 1997) on all patients seen at the ophthalmic unit at the Singapore General Hospital's emergency service. Data on clinical presentation, type and cause of injury and use of eye protective devices (EPD) were collected via a standardised interview and examination. RESULTS: A total of 870 persons presented with a diagnosis of ocular trauma, out of the 1,631 patients seen during the study period. Compared with non-trauma cases, trauma cases were more likely to be male (odds ratio (OR): 4.2, 95% confidence interval (95% CI): 3.2, 5.4), non-residents (OR: 6.2, 95% CI: 3.7, 10.5), younger than 40 years of age (OR: 3.2, 95% CI: 2.7, 4.1) and less likely to require follow-up or hospital admission (OR: 0.2, 95% CI: 0.2, 0.3). The three most common types of injuries were superficial foreign body (58.2%), corneal abrasion (24.9%) and blunt trauma (12.6%), while open globe injury occurred in only 17 cases (2%). Comparison with a 10% random sample of all cases seen in the previous 9 months (n = 284) revealed no significant time variation in the types of injuries (p = 0.63). Work-related injuries accounted for 590 (71.4%) cases, where grinding, cutting metal and drilling were the specific activities in more than 90% of the cases. In appropriate settings, only 21.7% of patients with work-related injuries used EPD; 43.7% were provided with EPD, but did not use them at the time of injury; and the remaining 34.6% reported that EPD were not provided. CONCLUSIONS: Ocular trauma at the emergency service level in Singapore involved mainly young non-resident men, were work-related and associated with well-defined activities, and were generally minor. The low prevalence of EPD use reinforces the need for a review of the design and implementation of occupational eye safety programmes, especially among non-resident workers.

Duke Scholars

Author Tien Yin Wong Ophthalmology