PURPOSE:Ophthalmic trauma is a substantial yet overlooked public health challenge, pertinent across all age groups, geographies, and socioeconomic statuses. Despite being largely preventable, it constitutes a major cause of monocular vision loss and long-term disability-adjusted life years among ophthalmic conditions, with a disproportionately high burden in low- and middle-income countries. Integrating original data from the International Globe and Adnexal Trauma Epidemiology Study (IGATES) registry, this hybrid perspective provides an overview of the global burden of ophthalmic trauma and emphasizes the urgent need for coordinated public health strategies focused on prevention and intervention. DESIGN:Perspective and multinational retrospective descriptive cohort study using registry-based real-world data. PARTICIPANTS:8238 patients with clinical evidence of ophthalmic trauma from 32 tertiary centers across 12 countries. METHODS:Data from 8238 patients with clinical evidence of ophthalmic trauma within the IGATES registry were analyzed, and descriptive statistics were utilized to characterize patient demographics, injury patterns, timing of presentation, and visual outcomes. MAIN OUTCOME MEASURES:Primary outcomes included type and setting of trauma, duration to presentation, presence of eye protection, and best-corrected visual acuity (BCVA) at final follow-up. RESULTS:In this 8238-patient cohort, 78.5% were male and the mean age was 31.4 years. Closed-globe injuries accounted for 56.9% of cases, whereas open-globe injuries comprised 34.0% of cases. Seventy percent of patients presented more than 12 hours after injury. Thirty percent had a final BCVA worse than 6/60 and 7.0% had no light perception. More eye injuries occurred at home than elsewhere (38.2%), followed by the workplace (19.4%) and road traffic accidents (8.8%). Eye protection was not worn in almost all cases (99.0%). CONCLUSION:This perspective calls for a shift in framing, for ophthalmic trauma not to be treated as an isolated clinical issue but prioritized as a preventable public health concern. Opportunities, from strengthened legislation and enforcement to heightened community awareness and system-level preparedness, are further outlined to reduce the burden of ophthalmic trauma and enhance care.
Eine Endophthalmitis infolge mikrobieller Keratitis (MK) ist ein seltener, aber gravierender ophthalmischer Notfall, der sich durch diagnostische und therapeutische Herausforderungen aufgrund geringer Hornhauttransparenz auszeichnet. Auch wenn sie weniger als 10
Objectives: The objective of the study is to systematically compare biological and structural properties of fresh, cryopreserved, lyophilized, and dehydrated human amniotic membrane (AM) and to quantify sufficiently comparable outcomes across preservation methods. Material and Methods: PubMed/MEDLINE was searched for comparative human AM studies published from January 2000 to March 10, 2026. Eligible studies compared at least two preservation or preparation modalities and reported biochemical, cellular, structural, mechanical, or ophthalmic outcomes. Quantitative syntheses used log ratios of means and random-effects models with restricted maximum likelihood and modified Hartung-Knapp confidence intervals. Methodological limitations were assessed with domains tailored to ex vivo experiments. Results: Of 497 records screened, 48 reports were sought, 46 were assessed in full text, and 44 studies were included; six unique studies contributed to two exploratory meta-analyses. For epidermal growth factor, the pooled dried/dehydrated-to-frozen ratio of means was 1.54 (95% confidence interval [CI], 0.35–6.70; I2 = 92.0%). For cellular viability, the cryopreserved-to-fresh ratio was 0.32 (95% CI, 0.03–3.11; I 2 = 96.2%) using the placental-region estimate and 0.44 (95% CI, 0.07–2.60; I 2 = 90.9%) using the reflected-region sensitivity estimate. Neither synthesis established superiority. Conclusion: Preservation method influences human AM properties, but the quantitative evidence is sparse, heterogeneous, and protocol-dependent. Current data do not support a universal hierarchy of preservation modalities; selection should reflect the biological property required, processing quality, and clinical logistics.
OBJECTIVES:Characterise the international variation in ophthalmic trauma and determine risk factors associated with visual and anatomical outcomes for low-, middle- and high-income countries. SUBJECTS/METHODS:Observational multi-centre cohort study using data from the International Globe and Adnexal Trauma Epidemiological Eye Study (IGATES) from April 2014 to August 2023. Data on acute presentations of ophthalmic injury including open/closed globe injury, and/or Adnexal/orbital involvement, and/or intraocular/ intraorbital foreign body were collected and Ocular Trauma Score (OTS) was calculated. A total of 5350 patients (5557 eyes) from 31 centres in 12 countries were included. The main outcome measures included demographics, mechanism and setting of injury, and presenting and final visual outcomes. Descriptive statistics, Kruskal-Wallis tests and multinomial logistic regression (MLR) analysis are presented, with correction performed using the Hochberg method. P values less than 0.005 were significant. RESULTS:Age, gender, presenting and final best-corrected visual acuity were all strongly associated with country (p < 0.005). Poor final visual outcomes were strongly associated with OTS predictions, type of injury (p < 0.005) and delayed presentation as well as firework injuries. High-income countries (HIC) showing reduced duration to presentation (HIC 5 h) and increased improvement in visual acuity (HIC -0.40) compared to low to middle-income countries (LMICs) (28 h) (-0.19). MLR analysis identified a significant association between countries' income classification and BCVA worse than 6/60, presence of scleral, iris, limbus injury and surgery being undertaken (p < 0.005). CONCLUSION:Data from 31 centres internationally identified differences in demographic trends for each country. Age was identified as a risk factor for eye injuries. Low- and middle-income countries were associated with longer delays to presentation, smaller gains in BCVA and poorer visual outcomes. IGATES provides an opportunity to collect global data on ophthalmic trauma to facilitate improved management and prevention strategies.
Endophthalmitis secondary to microbial keratitis (MK) is a rare but devastating ophthalmic emergency characterized by diagnostic and therapeutic challenges due to poor corneal clarity. Although it accounts for less than 10
