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Intimate partner violence as a mechanism of traumatic ocular injury in women

Published:August 25, 2018DOI:https://doi.org/10.1016/j.jcjo.2018.05.017

      ABSTRACT

      Objective

      Determine the prevalence of intimate partner violence (IPV) as a mechanism of traumatic ocular injury in women, typical injury patterns, and the clinical course of affected patients. Encourage IPV screening and safety assessment in patients presenting with characteristic ocular trauma.

      Methods

      Medical records of 211 female patients with traumatic ocular injuries evaluated at the University of Iowa Hospitals and Clinics between January 1995 and January 2015 were reviewed to determine the rate of IPV as a mechanism of ocular trauma. Twenty-one patients were excluded due to no documented trauma.

      Results

      Leading causes of traumatic ocular injuries in the 190 female patients included were accidental trauma with an inanimate object (n = 70/190, 36.8%), falls (n = 52/190, 27.4%), motor vehicle collisions (n = 21/190, 11.1%), and assault (n = 16/190, 8.4%). In 2.1% of cases (n = 4/190), no mechanism of traumatic injury was documented. Assault was the fourth leading mechanism of injury accounting for 8.4% of cases (n = 16/190), with IPV accounting for more than one third of cases with a documented perpetrator (n = 5/13). No perpetrator was documented in 18.8% (n = 3/16). All 5 patients with IPV-related injuries sustained scleral laceration or rupture; 4 out of 5 patients had no light perception vision and ultimately required enucleation.

      Conclusion

      IPV is an important mechanism of traumatic ocular injury. IPV-associated injuries tend to be severe in nature, as demonstrated by the high rate of globe laceration or rupture and subsequent enucleation in the study population. By appropriate screening and referral, ophthalmologists have an opportunity to redirect a potentially devastating course.

      Résumé

      Objectif

      Déterminer la prévalence de violence conjugale (VC) à l'origine d'un traumatisme oculaire chez les femmes, décrire les lésions typiques et brosser un tableau de l’évolution clinique des patientes. Encourager en outre le dépistage de VC et l’évaluation de la sécurité des patientes qui ont subi un traumatisme oculaire caractéristique de VC.

      Méthodes

      Les dossiers médicaux de 211 patientes qui présentaient un traumatisme oculaire et qui ont été évaluées dans un hôpital ou une clinique de l'université de l'Iowa entre janvier 1995 et janvier 2015 ont été passés en revue afin de déterminer le taux de VC à l'origine du traumatisme oculaire. Vingt et une patientes ont été exclues en raison de l'absence de documentation d'un tel traumatisme.

      Résultats

      Voici les principales causes de traumatisme oculaire chez les 190 femmes incluses à l’étude : blessure accidentelle avec un objet inanimé (n = 70/190; 36,8 %), chute (n = 52/190; 27,4 %), accident de véhicule (n = 21/190; 11,1 %) et voie de fait (n = 16/190; 8,4 %). Dans 2,1 % des cas (n = 4/190), aucun mécanisme à l'origine du traumatisme ne figurait au dossier. Les voies de fait arrivaient en quatrième position des causes de traumatisme oculaire et comptaient pour 8,4 % des cas (n = 16/190); plus du tiers des cas dont l'auteur était connu relevaient de la VC (n = 5/13). Aucun auteur n'a été identifié dans 18,8 % des cas (n = 3/16). Les 5 patientes qui avaient subi un traumatisme oculaire dans le cadre d'un épisode de VC présentaient une lacération ou une rupture du globe oculaire; 4 patientes sur 5 ne percevaient aucune lumière et ont dû subir une énucléation.

      Conclusion

      La VC est une cause importante de traumatisme oculaire. Les lésions liées à la VC ont tendance à être graves, comme le démontre le taux élevé de lacération ou de rupture du globe oculaire et d’énucléation subséquente au sein de la population à l’étude. En assurant un dépistage convenable des patientes et en les dirigeant vers les instances appropriées, les ophtalmologistes sont en mesure de redresser une situation à risque élevé.
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