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Invited Commentary
August 2018

Uncovering Reasons Why Acute Ocular Injuries in Children May Be Declining

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor
  • 2Department of Neurology, University of Michigan, Ann Arbor
JAMA Ophthalmol. 2018;136(8):904. doi:10.1001/jamaophthalmol.2018.2059

Acute ocular injuries are a leading cause of acquired vision loss in children, and most cases are preventable.1,2 Recently, an epidemiologic study of eye-related emergency department (ED) visits found a decreased incidence of visits for injury in people of all ages compared with previous estimates.3 Given the long-term social and financial consequences that ocular injuries can have on children and their families, it is important to understand if these trends apply to children and, if so, what underlying mechanisms might exist. In this issue of JAMA Ophthalmology, Matsa et al4 explore trends, mechanisms of injury, and the risk of vision loss by presenting updated estimates of acute ocular trauma in children presenting at US EDs from 2006 to 2014. The authors used the Nationwide Emergency Department Sample, a nationally representative administrative database developed for the Healthcare Cost and Utilization Project. Visits to EDs because of acute ocular injuries were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes, sometimes coupled with a mechanism of injury code (E-code). Because longitudinal data on visual outcomes were not in the data set, the authors asked clinical ophthalmologists to classify the codes into 3 categories for risk of permanent vision loss (high, variable, and low).

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