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 1631 patients seen during the study period. Compared with non-t rauma cases, trauma cases were more likely to be male (odds ratio (OR): 4.2 , 95% confidence interval (95% CD: 3.2, 5.4), non-residents (OR: 6.2, 95% C I: 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 b ody (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 s ample of all cases seen in the previous 9 months (n = 284) revealed no sign ificant time variation in the types of injuries (p = 0.63). Work-related in juries accounted for 590 (71.4%) cases, where grinding, cutting metal and d rilling were the specific activities in more than 90% of the eases. In appr opriate settings, only 21.7% of patients with work-related injuries used EP D; 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 invol ved mainly young nan-resident men, were work-related and associated with we ll-defined activities, and were generally minor. The low prevalence of EPD use reinforces the need for a review of the design and implementation of oc cupational eye safety programmes, especially among non-resident workers.