[Epidemiology of severe eye injuries. United States Eye Injury Registry (USEIR) and Hungarian Eye Injury Registry (HEIR)]

Abstract

Background: Both in industrialized and in developing nations, the devastating impact of ocular trauma on society is increasingly recognized. Lacking standardized surveillance systems, however, comparable epidemiological information has not been available previously.

Methods: For several years, the United States Eye Injury Registry (USEIR) and the Hungarian Eye Injury Registry (HEIR) have been collecting data on all types of serious ocular trauma, based on identical operating criteria and using standardized reporting forms. We performed a retrospective analysis comparing the two datasets, containing over 8,400 injuries from the U.S. and over 1,200 injuries from Hungary.

Results: Sixty percent of patients in the U.S. and 52% of patients in Hungary were less than 30 years of age, with an at least 80% male preponderance in both registries. The home was the most frequent place of injury in both countries (USEIR: 41%, HEIR: 35%); industrial premises represented no more than 14%. Guns were responsible for 12% of cases in the USEIR (HEIR, 1%). Champagne corks were identified as a unique and relatively common source of eye injury in Hungary (1.4%, as opposed to 0.07% in the U.S.). In the USEIR, 16% of injuries were caused by assault (HEIR, 24%; chi-square value = 36.7, p < 0.0000001). The enucleation rate was 12% in the U.S. and 1% in Hungary.

Conclusions: The different findings in the two countries identify certain areas for the implementation of preventive measures (supplying champagne bottles with warning labels and a coordinated fight against violence in Hungary, stricter fireworks legislation in the U.S., public awareness for home injuries in both countries, etc.). Based on the encouraging results from this study, we plan to continue our efforts using modified reporting forms and an upgraded software. We invite additional countries to adopt the USEIR model.