Epidemiology of motor vehicle accident-associated ocular trauma.

Purpose: The objective is to investigate trends in cases of motor vehicle accident-associated (MVA-associated) ocular trauma in which the patient was the driver of the motor vehicle.

Methods: The study utilizes data from the 2007-2014 National Trauma Databank (NTDB), a national trauma registry. Status as the driver of the motor vehicle was identified using E-Codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Trauma diagnoses were identified using D-Codes from the ICD-9-CM. Statistics were performed using IBM SPSS Version 23.

Results: We identified 49,660 cases of ocular trauma secondary to an MVA with a 25.3% increase in injuries over the 8-year time period. Men comprised 68.6% (34,057) of cases. Orbital floor fractures (OFFs) were the most commonly observed ocular injury, occurring in 17,647 (35.5%) cases. There were 2,787 cases of open globe injury (OGI) with the highest proportion of cases in the 65 + age group (6.5%). OGIs were seen in 3.0% of cases with OFFs vs. 7.1% in those without. Drivers under 18 were more likely to have optic pathway/cranial nerve injuries (4.4%) and ocular/adnexal contusions (41.2%) than adult drivers. The mortality rate was 4.3% and was highest in the 65 + age group (9.4%).

Conclusion: Men and young adults comprised the majority of cases of MVA-associated ocular trauma. OFFs were seen in approximately one-third of cases of ocular trauma. OGIs were less commonly observed when a concurrent OFF was observed. Though the overall mortality was 4.3%, there was significant variation by age group.