Consumer product-related eye injury in the United States, 1998-2002.

PROBLEM: Eye injury is currently a leading cause of visual impairment and monocular blindness in the United States. Information regarding consumer products associated with eye injuries can have important implications for the prevention of these injuries. METHODS: The National Electronic Injury Surveillance System (NEISS) was used to describe the types of consumer products associated with emergency department treated eye injuries in the United States from 1998 through 2002. RESULTS: The leading product type associated with eye injuries was welding equipment followed by household cleaners, basketball equipment, workshop equipment, and adhesives. Eye injuries attributed to hardware, tools, construction, sports, toys, and lawn equipment were more common among males. In females, eye injuries attributable to chemicals, housewares, storage and organization, and bed and bath items were more common. Differences were also apparent across the age spectrum. CONCLUSION: This study identified specific products and categories of products frequently associated with eye injury and prevention initiatives should focus on these items. IMPACT ON INDUSTRY: This study has identified consumer products associated with eye injuries requiring medical treatment in the United States. Manufacturers of these products could be encouraged to add or strengthen safety messages regarding the potential for eye injury.

Effect of cataract surgery on falls and mobility in independently living older adults.

OBJECTIVES: To determine the effect of cataract surgery on the occurrence of falls and mobility and balance problems in older adults with cataract. DESIGN: Longitudinal follow-up study. SETTING: Clinical Research Unit, University of Alabama at Birmingham. PARTICIPANTS: Persons aged 55 and older with a cataract were recruited from 12 eye clinics in Alabama from October 1994 through March 1996. Participants were classified into two groups: those who had cataract surgery (surgery group, n=122) and those who had not (no-surgery group, n=92). MEASUREMENTS: At baseline and 1-year follow-up visits, information on the occurrence of falls and mobility and balance problems was collected based on subjects' recall of events during the prior 12 months. RESULTS: After adjusting for demographic, behavioral, medical, and visual characteristics, there was no difference between the two groups in the likelihood of falling (risk ratio (RR)=0.96, 95% confidence interval (CI)=0.64-1.42) or in having mobility (RR=0.81, 95% CI=0.55-1.18) or balance difficulties (RR=0.71, 95% CI=0.37-1.39). CONCLUSION: Cataract surgery had no association with the occurrence of falls or mobility or balance problems in independently living older adults with a cataract.

Gun-related eye injury in the United States, 1993-2002.

OBJECTIVE: To present the descriptive epidemiology of gun-related eye injury in the United States from 1993 through 2002. METHODS: Data from the National Electronic Injury Surveillance System was used to estimate the number of patients treated in the United States for gun-related eye injury (GEI) (air guns and firearms), air gun-related eye injury (AEI) (BB/pellet guns and rifles) and firearm-related eye injury (FEI) (all powder discharge guns) during the time period 1993 through 2002. Rates were calculated according to age, gender, race, weapon type and circumstances surrounding the injury event (e.g., locale and intent). RESULTS: The rate of gun-related eye injury in the United States declined to 7.5 per 1,000,000 in 2002 from 14.8 per 1,000,000 in 1993, representing a decline of approximately 5.4% per year (p = 0.0002), due primarily to a decline in the rate of FEI (6.7% per year, p = 0.029). The rate of AEI was relatively constant. GEI rates were highest among those aged 10-19 years, males, and Blacks. The overall rate of AEI was higher than the rate of FEI (6.0 per 1,000,000 and 5.1 per 1,000,000, respectively). According to race, the rate of FEI was higher than the rate of AEI in Blacks whereas the rate of AEI was higher than the rate of FEI in Whites and Hispanics. The majority of GEIs occurred at home and were unintentional. CONCLUSION: The rate of gun-related eye injury in the United States declined from 1993 through 2002 primarily due to a reduction in firearm-related eye injury, whereas the rate of air gun-related eye injury remained constant. Persons who were young, Black, and male were at highest risk for gun-related eye injury.

3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitors and the presence of age-related macular degeneration in the Cardiovascular Health Study.

OBJECTIVE: To evaluate both the use of cholesterol-lowering medications as a group and the use of statins specifically with regard to the risk of age-related macular degeneration (AMD). METHODS: A case-control study was conducted using data from the Cardiovascular Health Study, a population-based prospective study of adults enrolled from 4 communities in the United States in 1989 and 1990. Individuals with AMD (cases) and those without AMD (controls) were compared with regard to their use of cholesterol-lowering medications and statins. RESULTS: Nearly equal proportions of cases and controls used cholesterol-lowering medications, both before adjustment (odds ratio, 0.92; 95% confidence interval, 0.70-1.21) and after adjustment for selected confounding variables (age, sex, and race) (odds ratio, 1.35; 95% confidence interval, 0.98-1.87). Statin use was also found to be similar among cases and controls (odds ratio, 0.98; 95% confidence interval, 0.73-1.30). After controlling for the aforementioned 3 confounders (odds ratio, 1.40; 95% confidence interval, 0.99-1.98), we noted a modest trend for statin users to have an increased risk of AMD. CONCLUSION: The results suggest that no association exists between having used cholesterol-lowering medications and AMD. However, there was a suggestion that statin use might increase the risk of AMD.

Health-related quality of life and psychosocial characteristics of patients with benign essential blepharospasm.

OBJECTIVE: To examine vision-targeted health-related quality of life and psychosocial characteristics in patients with benign essential blepharospasm (BEB) compared with patients with hemifacial spasm (HFS). METHODS: Persons with BEB (n = 159) or HFS (n = 91) were identified based on International Classification of Diseases, Ninth Revision, Clinical Modifications codes with subsequent verification by record abstraction. Information regarding demographics, health characteristics, disease characteristics, and vision-targeted health-related quality of life was obtained through a telephone interview. RESULTS: For patients with BEB and HFS, the composite scores and subscale scores on the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) were low. Compared with patients with HFS, patients with BEB reported more depressive symptoms (P = .03), met the criteria for generalized anxiety disorder (P = .007), had lower NEI-VFQ-25 composite scores (P<.001), and had lower NEI-VFQ-25 subscale scores regarding general vision (P = .03), ocular pain (P<.001), distance activities (P = .001), driving (P<.001), and all of the vision-specific subscales addressing psychosocial issues. CONCLUSIONS: Compared with patients with HFS, those with BEB experience a greater reduction in vision-targeted health-related quality of life and are more prone to symptoms of depression and anxiety. This underscores the inadequacy of current treatment options for BEB in light of the fact that these patients had been undergoing standard-of-care treatments for some time.

Trends in eye injury in the United States, 1992-2001.

PURPOSE: To report the trends of eye injury in the United States from 1992 through 2001. METHODS: The National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, and the National Hospital Discharge Survey were used to collect information on eye injuries from 1992 to 2001. Rates of eye injury per 1000 population were calculated according to age, gender, and race. RESULTS: From 1992 through 2001, the overall estimated rate of eye injury ranged from 8.2 to 13.0 per 1000 population. During this period the incidence of eye injury significantly declined overall, in persons aged 39 years and younger, in both genders, and in the black and white populations (all P <0.05). CONCLUSIONS: From 1992 through 2002, the incidence of eye injury in the United States declined overall, in persons aged 39 and younger, in both genders, and in both racial groups. Certain segments of the population, however, continued to be at high risk (i.e., males and persons aged 39 and younger) of eye injury and represent those groups toward whom prevention resources should be directed.

Visual field defects and the risk of motor vehicle collisions among patients with glaucoma.

PURPOSE: To evaluate the association between visual field defects in the central 24 degrees field and the risk of motor vehicle collisions (MVCs) among patients with glaucoma. METHODS: A nested case-control study was conducted in patients with glaucoma aged 55 or more. Cases were patients who were involved in a police-reported motor vehicle collision (MVC) between January 1994 and June 2000; controls were those who had not experienced an MVC at the time of their selection. For each patient, an Advanced Glaucoma Intervention Study (AGIS) score was calculated on automated visual fields collected with the 24-2 or 3-2 programs. RESULTS: With respect to the better-eye AGIS score, compared with patients with no visual field defect, those with severe defects (scores 12-20) had an increased risk of an MVC (odds ratio [OR] 3.2, 95% CI 0.9-10.4), although the association was not statistically significant. Moderate (6-11) or minor field defects (1-5) in the better eye were not associated with the risk of involvement in a crash. In the worse eye, patients with moderate or severe field defects were at significantly increased risk of an MVC (OR 3.6, 95% CI 1.4-9.4 and OR 4.4, 95% CI 1.6-12.4, respectively) compared with those with no defects. Minor field defects in the worse eye did not increase risk of MVC (OR 1.3, 95% CI 0.5-3.4). CONCLUSIONS: Patients with glaucoma who have moderate or severe visual field impairment in the central 24 degrees radius field in the worse-functioning eye are at increased risk of involvement in a vehicle crash.

Effect of cataract surgery on cognitive function in older adults.

OBJECTIVES: To assess whether cataract surgery has an effect on cognitive function in older adults. DESIGN: Longitudinal. SETTING: Assessment of patients seen in eye clinics. PARTICIPANTS: Patients with no cataract (n=92), patients with cataract who elected surgery (n=122), and patients with cataract who declined surgery (n=87). MEASUREMENTS: At baseline and 1-year follow-up visits, the following information was obtained: demographic, health behavior, general health status, medication use, depressive symptoms, cognitive function, and visual function information. This information was compared within and between groups at baseline and follow-up visits. RESULTS: Mattis Organic Mental Syndrome Screening Examination scores at baseline and follow-up varied across the three groups, with the cataract/no surgery group having the highest scores (more cognitive impairment) and the no-cataract group having the lowest scores (less cognitive impairment). For the within-group analysis, at follow-up, the cataract/no surgery group and the cataract/surgery group had significantly less cognitive impairment (P<.001), whereas the no-cataract group experienced no change. For those with cataract, there were no associations between changes in visual function and cognitive function. CONCLUSION: Improvement in cognitive function may occur after cataract surgery but cannot be attributed to the cataract surgery per se or to improved visual function. Clinicians may find this information useful when discussing the nonvisual outcomes of cataract surgery with patients.