• Jennifer H Court, Lucy M Lu, Nancy Wang, and McGhee Charles N J CNJ Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
• Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
• Clin. Experiment. Ophthalmol. 2019 May 1; 47 (4): 469-477.

ImportanceOpen-globe injuries (OGI) are a leading cause of monocular blindness world-wide with considerable cost to the individual and society.BackgroundTo characterize the epidemiology, severity and outcomes of OGI treated at a major ophthalmology centre in New Zealand.DesignRetrospective study.ParticipantsA total of 385 eyes of 381 patients over a 10-year period.MethodsEligible patients were identified using diagnosis and surgery codes on hospital discharge summaries. Clinical notes were reviewed to determine patient demographics, injury details, treatments and outcomes.Main Outcome MeasuresComplications of injury, visual acuity at 3 months and final follow-up, and final status of the eye.ResultsThe estimated annual incidence of OGI was 2.8 per 100 000. Working-age males predominated but age at injury ranged from 9 months to 90 years. Maori and Pacific peoples were over-represented. Injuries were severe with 58.7% presenting with vision of hand movements or worse. Penetrating injuries (56.4%) were most common, followed by globe ruptures (35.6%). Major complications included retinal detachment (15.8%), enucleation/evisceration (9.1%), phthisis bulbi (9.9%), endophthalmitis (2.6%) and sympathetic ophthalmia (0.26%). Despite the injury severity, 46% of eyes achieved final BCVA of ≥6/12. The Ocular Trauma Score (OTS) was a useful prognostic tool for stratifying severity of injury and predicting visual outcome (Fisher's exact test P < 0.001).Conclusions And RelevanceThe incidence and severity of OGI in NZ are comparable to global statistics. Surgical repair can effectively recover vision, predicted well by the OTS. We identified at-risk groups to target with education and prevention strategies.© 2018 Royal Australian and New Zealand College of Ophthalmologists.

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