Population-based study of self-reported ocular trauma in Fiji

Abstract

Background: To characterize causes, risk factors and outcomes for ocular trauma among adults aged ≥40 years in Fiji.

Design: Population-based cross-sectional survey; multistage cluster random sampling.

Participants: 1381 (= 73.0% participation); eight provinces on Viti Levu.

Methods: Interview-based questionnaire. Visual acuity measurement. Dilated ocular examination.

Main outcome measures: Circumstances, management and consequences of self-reported ocular trauma.

Results: Of participants, 20.6% recalled ocular trauma: being Melanesian (P < 0.001) and male (P < 0.001) were predictive. Age at injury was ≤15 years for 13.0%: 78.4% occurred at home; 72.4% caused by sharp objects. For injury at >15 years: 38.5% occurred inside the home, most by sharp objects (51.6%) and domestic violence (28.4%); agricultural activities caused 20.6% of injuries; non-agricultural workplace incidents caused 16.2%, with chemicals responsible for 27.5% of these; public alcohol consumption was associated with 13.8% of injuries, mostly by assault (91.2%). Conventional medical services were the primary source of care for 47.2% of injured participants: 61.9% attended on injury day. For trauma: sample prevalence of vision impairment in at least one eye was 1.7% (95% confidence interval 1.1-2.4%), and 0.1% (95% confidence interval 0.02-0.5) for bilateral blindness. Injury at ≤15 years (P = 0.008) and at the workplace (P = 0.044) were predictive of ongoing vision impairment. Of visually impaired eyes, 36% had corneal opacity that may have been caused by relatively minor trauma.

Conclusions: Ophthalmic service strengthening (including minor corneal trauma management) and specific injury prevention strategies (including behaviour change education and advocacy for legislation) are required to decrease the ocular trauma burden in Fiji.