A Review of Anterior Segment Injuries at Kikuyu Eye Unit in Kenya, a 3-year Retrospective Study

Abstract

Background Ocular trauma is a major worldwide problem to health. It can cause severe visual impairment or visual loss. Its impact can be felt at the individual and society level. It affects the cost, time spent accessing treatment and decline in economic productivity. Ocular trauma is preventable and public awareness may aid in reducing the occurrence of eye injuries. The Anterior segment is the most commonly injured segment, and it requires meticulous repair in order to restore ocular integrity and avoid complications. Objective To determine the pattern, interventions and outcome of anterior segment injuries at the Kikuyu Eye Unit. Study design and study centre A retrospective hospital-based case series at Kikuyu Eye Unit, a high volume eye centre located in Kiambu County. Participants and methods Files of all patients with anterior segment injuries treated at Kikuyu Eye Unit, between 1st January 2017 to 31st December 2019, were retrieved. Patients with posterior segment injuries were excluded. Formula with finite population correction (Daniel WW 1999) was used to calculate the sample size. Data management Data was recorded using a questionnaire. It was input and analysed using Statistical Package for Social Scientists(SPSS). The mean, median, and percentages were included in the descriptive analysis. They are displayed in tables and graphs as needed. 2 Results A total of 503 files were retrieved, 296 with both anterior and posterior segment trauma excluded, and 207 studied. The male:female ratio was 2.4:1. The mean age of presentation was 19.3 years and the primarily affected age group was 1-10 years. The most frequent place where injuries occurred was at home (36.2%), followed by work place (20.8%). Stick was the most common causative agent of trauma (24.8%). Open globe injuries accounted for (65.4%), and right eye (53.1%) was the most commonly injured eye. Seven patients were injured in both eyes. The average time between injury and presentation to KEU was 3 days, and the average time between admission and surgery was 1 day. Corneal perforation was the most common presentation (45.8%) with corneal opacity being the most common complication (22.0%). There was a statistically significant improvement in eyes that had post treatment best corrected visual acuity documented, p<0.001. Conclusion Anterior segment injuries occurred commonly in children and men. Most patient had open globe injuries, corneal perforation was the most common presentation. There was improvement in post treatment BCVA. This calls for preventive strategies by use of protective eyewear and supervised child play