Determinants of Visual Outcomes in Open Globe Injuries: A 5-year Retrospective Study from a Tertiary Hospital in Northern Tanzania

Abstract

Objectives: This study aimed to assess factors affecting visual outcomes among Open Globe Injury (OGI) patients attending the KCMC eye department from 2015 to 2020. Methodology: A retrospective review of medical records was conducted for Open Globe Injury (OGI) patients aged three years and above, excluding those with missing data, prior trauma, or pre-existing ocular diseases. Data were analyzed using STATA version 17. Categorical variables were summarized using frequencies and percentages, while numerical variables were analyzed using means and interquartile ranges. The chi-square test assessed differences in postoperative visual acuity (VA), and a modified Poisson regression model identified factors associated with poor VA (p<0.05 considered significant). Results: A total of 184 open globe injury patients were included, with a majority being male (70.1%) and from rural areas (80.4%). Penetrating injuries were the most common (60.9%), and Zone I injuries predominated (59.3%). Only 29.9% achieved good postoperative best-corrected visual acuity (BCVA). Poor visual outcomes were associated with delayed surgery (>2 hours post-injury), larger ocular injuries, type of globe injury, anterior chamber status, and type of ocular surgery. Conclusion: Poor visual outcomes following Open Globe Injuries remain a significant concern at KCMC, with less than one-third of patients achieving good postoperative visual acuity. Delayed surgical intervention, extent and type of injury, anterior chamber involvement, and the surgical approach were significant determinants of visual prognosis. These findings highlight the importance of early presentation and timely management to improve visual outcomes in affected patients. Furthermore, the results emphasize the need for increased public health efforts to raise awareness about eye protection, particularly among individuals in high-risk occupations, to reduce the incidence of preventable ocular trauma.