Background
Since the start of the COVID-19 pandemic in 2020, patterns of trauma and injury have changed. The immediate lockdown period showed fewer ED visits but a higher proportion of severe injury. The objective of this study is to compare the incidence of eye-related injuries presenting at a single institution occurring in 2019 versus 2020. 

Methods
A retrospective study was conducted on 824 patients presenting to the ED from 01/01/2019 through 12/31/2020 at a freestanding Level 1 Trauma Center in the Midwest. Patients were >18 years old with any sort of ophthalmic trauma. Patients were organized by age, ethnicity, and gender. De-identified data from the Trauma Registry Database was filtered based on ICD codes relating the manner of injury, including the overarching categories of superficial, laceration, fracture, ocular trauma, and burns. 

Results
The number of distinct patients seen for eye-related traumas was 378 in 2019 and 446 in 2020. Most of the change from 2019 to 2020 arose from increases in lacerations and fractures, with lacerations increasing 24.5% and fractures increasing 27.0%. The number of fractures reported in each 3-month season following the initial March 2020 lockdown was 27.4-44.9% higher than the corresponding seasons in 2019. Superficial injuries marginally increased, while ocular trauma injuries decreased by 10.2%.

Demographically, the proportion of female patients compared to male patients increased from 2019 to 2020. There were increases in incidence across all age groups: 25.7% for age 18-30, 9.6% for age 31-50, 13.9% for age 51-65, and 25.7% for age >65. The proportion of ophthalmic trauma patients identified by self-reported race remained stable from 2019 to 2020, with approximately ⅓ patients identifying as Black/AA and ⅔ identifying as White.

Conclusion
Eye-related traumas increased during the initial COVID-19 wave through the end of 2020. We specifically found an increase in severe eye injuries including lacerations and fractures, although ocular traumas such as ruptured globes decreased. The drastic change in lifestyle mandated by COVID-19 lockdowns likely contributed to these changes, with more people sustaining injuries while completing home projects and a concurrent rise of intimate partner violence.

Changes in Incidence of Eye-Related Injuries from 2019 to 2020

Public Health and Health Policy | Ophthalmology

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