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Associations between socioeconomic status and open globe injury

Eye volume 39, pages 986–991 (2025)Cite this article

Subjects

Abstract

Objective

To examine associations between socioeconomic status (SES), as evaluated by the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI) and Distressed Communities Index (DCI), and the characteristics of open globe injury (OGI).

Subjects/Methods

Retrospective review of electronic medical records for patients treated for OGI at an academic Level I trauma centre between May 2009 and March 2021. Patient data included age, date of injury, mechanism of injury, visual acuity at presentation, concomitant orbital wall fracture, and ocular trauma score (OTS). The SVI and DCI scores were obtained based on the patient’s home zip code. Patients were classified based on individual mechanisms of injury and grouped into non-accidental vs. accidental cases.

Results

899 patients (75.0% male) were included. Average ± SD age (years), SVI, and DCI scores were 44.8 ± 22.7, 0.418 ± 0.207, and 37.9 ± 24.0, respectively. Younger age was associated with higher DCI and lower OTS score (p ≤ 0.002). Non-accidental trauma patients had lower OTS and higher SVI and DCI scores compared to accidental trauma (p < 0.001); firearm-associated ocular injuries (FAOIs) were associated with higher SVI and DCI scores (p < 0.001 and p = 0.040, respectively); domestic violence/assault was associated with worse OTS and higher DCI (p < 001). Falls and sports-related injuries correlated with lower DCI scores (p ≤ 0.031).

Conclusions

In our region, among patients with OGIs, lower SES scores were associated with younger age, FAOIs, and non-accidental injuries, including domestic violence/assault. Therefore, lower SES may be considered a risk factor for several distinct mechanisms of OGI.

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Fig. 1: Social Vulnerability Index (SVI) and Distressed Community Index (DCI) average trends for non-accidental and accidental cases over the study period.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

Unrestricted departmental grant from Research to Prevent Blindness, New York, NY

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Authors and Affiliations

  1. Department of Ophthalmology, University of Washington, Seattle, WA, USA

    Marlow Schulz, Alyssa C. Bonnell, Yewlin E. Chee, Shu Feng, Philip P. Chen & Karine D. Bojikian

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Contributions

KDB and PC were responsible for designing the study. KDB, MS, AB, YC, and SF were responsible for extracting and analysing data and interpreting results. KDB and MS were responsible for drafting the manuscript. PPC, AB, YC, and SF were responsible for reviewing and contributing to the final manuscript.

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Correspondence to Karine D. Bojikian.

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Schulz, M., Bonnell, A.C., Chee, Y.E. et al. Associations between socioeconomic status and open globe injury. Eye 39, 986–991 (2025). https://doi.org/10.1038/s41433-024-03537-9

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