Increased Number and Severity of Open Globe Injuries during COVID-19 Stay-at-home Orders

ABSTRACT

Purpose

To evaluate the occurrence and outcome of open globe injury during state-mandated COVID-19 stay-at-home orders compared to historical averages at a tertiary medical center in Portland, Oregon.

Methods

Open globe injury between January 1, 2015 and December 31, 2020 was identified using relevant procedure codes. The number of injuries, mechanism of trauma, and short-term outcomes of globes repaired during the study period of March 23, 2020 to July 6, 2020 when stay-at-home orders were in effect were compared to a cohort from the same 15-week time frame in 2015–2019. We also evaluated injuries occurring throughout 2020 as compared to the prior 5 years.

Results

263 consecutive open globe injuries were identified between January 2015 and December 2020. While Oregon’s stay-at-home orders were in effect, we observed a significant increase in the number of open globe injuries treated compared to the prior 5 years (p = .004). Twenty-four cases identified during the study period represent a 2-fold increase over the 2015–2019 average of 11.8 globe repairs during the same 15-week time period. Visual acuity < 20/200 at 6 months (p = .008) and secondary enucleation (p < .001) were more frequent during stay-at-home orders, and severity of injury as calculated by the Ocular Trauma Scores (OTS) was higher. Time-to-repair was similar between the two cohorts.

Conclusion

At our center, there was an increased number and severity of open globe injury during the period of mandatory COVID-19 stay-at-home orders. Visual acuity outcomes and risk for secondary enucleation were poorer compared to the reference cohort.

Abbreviations: Ocular Trauma Score (OTS), Open globe injury (OGI), Emergency department (ED), Oregon Health and Science University (OHSU)

KEYWORDS:

• injuries
• globe
• severity
• COVID
• Open globe injury

Acknowledgments

Supported by grant P30 EY010572 from the National Institutes of Health (Bethesda, MD), and by unrestricted departmental funding from Research to Prevent Blindness (New York, NY). AHS is a Consultant for Castle Biosciences, Inc.

Disclosure statement

None of the following authors have any proprietary interests or conflicts of interest related to this submission. AHS is a consultant for Castle Biosciences, Inc. and Immunocore.

This submission has not been published previously and is not simultaneously being considered for other publication.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.