Orbital fractures and concurrent ocular injury in a New Zealand tertiary centre.

Background: Orbital fractures are a common presentation to acute care and carry an associated risk of ocular injury, however, previous research has not investigated injury rates by fracture category. These patients are frequently assessed by non-ophthalmic clinicians, however, limited data exists regarding referral patterns and how this impacts recorded injury rates (1-3). Methods: We performed a retrospective review of all orbital fractures presenting to a tertiary hospital in Christchurch, New Zealand between March 2019 and March 2021. Data including mechanism of injury, fracture type, demographic characteristics, and associated ocular injury were recorded. Results: 284 patients with orbital fractures were identified. 41% of patients had isolated wall fractures, while 59% had complex orbitofacial fractures. Fractures were more common in males, and occurred more frequently in young individuals. The most common mechanism of injury was interpersonal violence (32%), followed by falls (23%). 41% of patients were reviewed by ophthalmology (n = 118). Of those, 33% had an associated ocular injury. Severe ocular injury (defined as vision threatening, requiring globe surgery or acute lateral canthotomy and cantholysis) occurred in 4.9% of those with formal ophthalmic review. 0.7% of patients required intraocular surgery or lateral canthotomy due to their orbital fracture. Conclusion: Orbital fractures have a high rate of concurrent ocular injury in our study population, though rates of subsequent intraocular surgery are low. There was no significant difference in injury rates between isolated and complex fracture categories. Vision-threatening ocular injury occurred in 4.9% of fractures.

Neonatal conjunctivitis in the New Zealand Midland region.

AIMS: To assess the incidence of chlamydial and gonorrhoeal neonatal conjunctivitis (CON and GON), across six district health boards in the greater Midland region of New Zealand. METHODS: All positive nucleic acid amplification test (NAAT) eye swabs for Chlamydia trachomatis and NAAT and bacterial eye swabs for Neisseria gonorrhoeae in infants under one year of age were retrieved from three laboratories from 2013-2016. Incidence density rates were calculated using births information from Statistics New Zealand. A subgroup analysis of Waikato and Tairawhiti cases were further analysed. RESULTS: Calculated rates for the Greater Midland region are CON, 145.9 per 100,000 births/year and GON, 3.79 per 100,000 births/year. For Tairawhiti and Waikato, the incidence of CON is 2.5 times greater in Maori than non-Maori (95% CI 1.3-5.1, P<0.01). There was no significant difference in mean NZDep13 for Maori vs non-Maori. Mean maternal age at birth was 20. CONCLUSIONS: Greater Midland region rates of CON and GON are higher compared to other international reported rates. For Tairawhiti and Waikato, rates of CON are significantly higher in Maori than non-Maori, although there is no difference in mean NZDep13 scores between Maori and non-Maori. CON appears to be a condition of babies of young mothers with higher deprivation.