Acil Servise Başvuran Adli Göz Vakalarının Değerlendirilmesi

Abstract

Amaç: Bu çalışmada, acil servise başvuran adli göz travmalarının demografik, sosyoekonomik ve klinik özelliklerinin değerlendirilmesi amaçlanmıştır.
Materyal ve metod: Çalışmaya, adli göz travması nedeniyle acil servise başvuran tüm olgular dahil edilmiştir. Olgular yaş, cinsiyet, sosyoekonomik durum, travma tipi, adli rapor bulguları ve klinik sonuçlar açısından retrospektif olarak incelenmiştir.
Bulgular: Çalışmaya dahil edilen 96 adli göz travması vakasının yaşları 1-72 arasında değişmekte olup ortanca yaş 20 idi. Olguların çoğunluğu erkek (%72,9), 18 yaş ve üzeri (%42,7) ve kentsel bölgelerde yaşayan bireylerden (%89,6) oluşmaktadır. Vakalar en fazla 2022 yılında görülmüş ve başvurular Mayıs ile Temmuz aylarında yoğunlaşmıştır. Travmaların en sık nedeni ev kazaları (%55,2) olup bunu iş kazaları ve darp izlemektedir. Olguların %72,9’u adli rapor açısından basit tıbbi müdahale ile giderilemez niteliktedir; 0-6 ve 7-11 yaş gruplarında bu oran daha yüksekken (%83,3 ve %95,8), 12-17 ve ≥18 yaş gruplarında basit müdahale ile giderilebilen olguların oranı artmaktadır (%30,8 ve %43,9, p<0,05). Gözde yabancı cisim varlığı ≥18 yaş grubunda daha sık gözlenmiş (%26,8, p<0,05) ve Korneal perforasyon olguları 12-17 (%50,0) ve ≥18 (%26,8) yaş gruplarında yoğunlaşmıştır (p=0,027). Cinsiyete göre kadınlarda ev kazaları, erkeklerde iş kazaları ve darp olguları daha sık saptanmıştır.
Sonuç: Adli göz travmaları çoğunlukla genç ve erkek bireylerde görülmektedir. Penetran yaralanmalar ön planda olup, yaş gruplarına göre yapılan analizde, çocukluk çağında BTM ile giderilemez olguların oranı anlamlı düzeyde daha yüksek bulundu.

Keywords

• Adli Göz Travması
• Acil Servis
• Klinik Özellikler
• Demografik Özellikler

Ethical Statement

Bu çalışma, Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüş olup Harran Üniversitesi Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (tarih: 18.11.2024; karar no: 24.18.13).

Evaluation of Forensic Eye Cases Presenting to the Emergency Department

Abstract

Background: This study aimed to evaluate the demographic, socioeconomic, and clinical characteristics of forensic eye injuries presenting to the emergency department.
Material and Methods: All cases presenting to the emergency department with forensic eye trauma were included in the study. The cases were retrospectively analyzed in terms of age, sex, socioeconomic status, type of trauma, medicolegal report findings, and clinical outcomes.
Results: The 96 forensic eye trauma cases included in the study ranged in age from 1 to 72 years, with a median age of 20. The majority of cases were male (72.9%), aged 18 years and older (42.7%), and resided in urban areas (89.6%). The highest number of cases occurred in 2022, with peak presentations observed in May and July. The most common cause of trauma was domestic accidents (55.2%), followed by occupational injuries and assaults. Overall, 72.9% of cases were classified as not amenable to simple medical intervention based on forensic evaluation; this proportion was higher in the 0-6 and 7-11 age groups (83.3% and 95.8%), whereas the proportion of cases treatable with simple intervention was greater in the 12-17 and ≥18 age groups (30.8% and 43.9%, p<0.05). The presence of intraocular foreign bodies was more frequent in the ≥18 age group (26.8%, p<0.05), and corneal perforations were most prevalent in the 12-17 (50.0%) and ≥18 (26.8%) age groups (p=0.027). When analyzed by sex, domestic accidents were more common in females, whereas occupational injuries and assaults were more frequent in males.
Conclusions: Forensic ocular traumas predominantly occur in young male individuals. Penetrating injuries are the most common, and analysis by age group revealed that the proportion of cases not manageable with simple medical intervention was significantly higher in childhood.

Keywords

• Forensic Eye Injury
• Emergency Department
• Clinical Features
• Demographic Characteristics

Ethical Statement

Bu çalışma, Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüş olup Harran Üniversitesi Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (tarih: 18.11.2024; karar no: 24.18.13).

References

1. 1. Kellermann AL. Crisis in the emergency department. N Engl J Med. 2006;355(13):1300-3.
2. 2. McCaig LF, Nawar EW. National Hospital Ambulatory Medical Care Survey: 2002 emergency department summary. Hyattsville (MD): US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2006.
3. 3. Washington RE, Andrews RM, Mutter R. Emergency department visits for adults with diabetes, 2010: Statistical brief 167. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD): Agency for Healthcare Research and Quality; 2013.
4. 4. Owens PL, Mutter R. Emergency department visits related to eye injuries, 2008: Statistical brief 112. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD): Agency for Healthcare Research and Quality; 2011.
5. 5. Gervasio KA, Camarena J, Hampton J, Chopra N, Kalosza B, Shumate L, et al. Demographic and socioeconomic disparities in receipt of ophthalmology consultation for facial trauma. BMJ Open Ophthalmol. 2023;8(1): e001259.
6. 6. Zhou Y, DiSclafani M, Jeang L, Shah AA. Open Globe Injuries: Review of Evaluation, Management, and Surgical Pearls. Clin Ophthalmol. 2022 Aug 10; 16:2545-59. 7. Li C, Fu Y, Liu S, Yu H, Yang X, Zhang M, Liu L. The global incidence and disability of eye injury: an analysis from the Global Burden of Disease Study 2019. EClinicalMedicine. 2023; 62:102134.
7. 8. Kousiouris P, Klavdianou O, Douglas KA, Chodosh J, Zemba M, Ratanapakorn T, et al. Role of socioeconomic status (SES) in globe injuries: a review. Clin Ophthalmol. 2022;16:25-31.
8. 9. Barake DA Omoto AL, Muthui G, Mutuma PK Eye injuries: causes and complications among adult population at an ambulatory eye center: a case of Nyamira County Referral Hospital Eye Unit. IOSR J Nurs Health Sci. 2025;14(1):53-62.

9. 10. Cillino S, Casuccio A, Di Pace F, Pillitteri F, Cillino G. A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in a Mediterranean area. BMC Ophthalmol. 2008;8:6.
10. 11. Boțoc T. A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in Bălți, Moldova. MedEspera. 2020;8:170.
11. 12. Kuhn F, Morris R, Witherspoon CD, Mann L. Epidemiology of blinding trauma in the United States Eye Injury Registry. Ophthalmic Epidemiol. 2006;13(3):209-216.
12. 13. Vats S, Murthy GVS, Chandra M, Gupta SK, Vashist P, Gogoi M. Epidemiological study of ocular trauma in an urban slum population in Delhi, India. Indian J Ophthalmol. 2008;56(4):313-6.
13. 14. Cao H, Li L, Zhang M, Li H. Epidemiology of pediatric ocular trauma in the Chaoshan Region, China, 2001-2010. PLoS One. 2013;8(4):e60844.
14. 15. May DR, Kuhn FP, Morris RE, Witherspoon CD, Danis RP, Matthews GP, et al. The epidemiology of serious eye injuries from the United States Eye Injury Registry. Graefes Arch Clin Exp Ophthalmol. 2000;238(2):153-7.
15. 16. Al-Mahdi HS, Bener A, Hashim SP. Clinical pattern of pediatric ocular trauma in a fast-developing country. Int Emerg Nurs. 2011;19(4):186-91.
16. 17. Soylu M, Sizmaz S, Cayli S. Eye injury (ocular trauma) in southern Turkey: epidemiology, ocular survival, and visual outcome. Int Ophthalmol. 2010;30(2):143-8.
17. 18. Onakpoya OH, Adeoye A, Adeoti CO, Ajite K. Epidemiology of ocular trauma among the elderly in a developing country. Ophthalmic Epidemiol. 2010;17(5):315-20.
18. 19. Wong TY, Klein BE, Klein R. The prevalence and 5-year incidence of ocular trauma: the Beaver Dam Eye Study. Ophthalmology. 2000;107(12):2196-202