Eye-Injury–Related Visits to the Emergency Department

There are >2.5 million eye injuries each year in the United States, and 50,000 people permanently lose all or part of their vision. Of those injuries, 44.1% occur at home, 800,000 are work related, and 14.7% of eye injuries among children ages 5 to 14 years are sports related.

It is estimated that >90% of all eye injuries are preventable with the use of protective eyewear. The Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality released Statistical Brief #112 compiling data on visits to emergency departments (EDs) related to eye injuries. The brief compares the characteristics of eye-related ED visits to all other types of injury-related visits (all differences between estimates, P≥.05). The brief includes data from 2008, when there were 636,619 eye-injury–related ED visits, a rate of 209 ED visits per 100,000 population. There were 29,482,454 ED visits in 2008 for all other injuries. Every day, on average, there were 1744 eye-injury–related visits compared with 80,774 ED visits for all other injuries.

Approximately 3.1% of patients seen in the ED for eye injuries were subsequently admitted to the hospital, compared with 8.1% of ED visits for all other types of injuries. Of the 616,766 treat-and-release eye-injury–related ED visits, 82.5% had a primary eye injury diagnosis; of the 19,853 eye-injury–related ED visits that resulted in admission to the hospital, 72.4% had a secondary eye injury diagnosis. The rate of ED visits related to eye injuries was 1.7 times higher for males than for females (262 visits per 100,000 population vs 158 visits per 100,000 population, respectively). The rate of ED visits for all other types of injuries was 1.2 times higher for males compared with females (10,400 vs 9007 per 100,000 population, respectively). Nearly three quarters (73.6%) of eye-injury–related ED visits were for patients <45 years of age; 28.3% were for patients <18 years of age and 45.3% were for patients 18 to 44 years of age.

The average age of patients seen in the ED for eye injuries was 31.5 years, compared with 35.4 years of age for ED visits for all other types of injuries. The average age of patients with eye injuries who were treated and released from the ED was 20 years younger than the average age of patients with eye injuries seen in the ED and admitted to the hospital (30.8 vs 51.2 years, respectively). Only 7.6% of patients with eye-injury–related ED visits were ≥65 years of age, compared with 13.5% of ED visits for all other types of injuries.

For patients in rural areas, there were 5.4 times as many ED visits related to eye injuries as there were for patients in urban areas (646 per 100,000 population vs 120 per 100,000 population, respectively). For other types of injuries, the difference was similar: 31,229 per 100,000 population in rural areas compared with 5317 per 100,000 population in urban areas. Nearly half (48.7%) of all eye injuries were diagnosed as an injury to the cornea, followed by laceration of the eyelid (9.3%) and bruise of the eye (7.3%). A similar pattern was found in the treat-and-release eye-injury–related ED visits.

Among eye injuries resulting in admission from the ED, the most common specific eye injuries were wounds to the ocular glands (16.9%), bruises to the orbital tissues (15.2%), and bruises of the eyelids (11.2%). The 5 most common causes of eye injuries were being struck by an object, such as being hit during a fight or being involved in a sports injury (31.1%); falls into an object (10.0%); fire or burns, such as from a caustic or corrosive substance (4.3%); motor vehicle traffic accident (3.3%); and environmental injuries, such as a bite from an insect or animal (3.2%). Among eye-related visits to the ED resulting in admission, falls were the most common cause of injury (36.1%), followed by motor vehicle traffic accident (19.1%) and being struck by an object (12.0%).