Yearly trends in the incidence of ocular traumas and the effects of COVID-19 pandemic: a nationwide population-based study of Korean data

BACKGROUND: Ocular trauma can cause irreversible visual impairment, and its incidence is higher than that of other ocular diseases in young patients. Past studies on ocular trauma have been limited in terms of small sample sizes, specific age groups, or a short period of assessment. Moreover, no studies have yet investigated the effects of changes in lifestyle during the coronavirus disease 2019 (COVID-19) pandemic on these trends. Therefore, we aimed to determine the yearly trends in the incidence of various ocular traumas over a 10-year period (2011–2020), and to evaluate the effects of the COVID-19 pandemic on these trends. METHODS: In this nationwide, population-based, cross-sectional study, we recorded the yearly number of patients diagnosed with hyphema and those who underwent open reduction surgery for orbital blowout fracture (BOF), primary closure of the cornea or sclera (PCCS), and intraocular foreign body (IOFB) removal. RESULTS: While the annual incidence of closed-globe injuries and PCCS decreased significantly in age groups less than 60 years over the past 10 years, the incidence of surgery for BOF and IOFB increased significantly in age groups greater than or equal to 60 years during the same period. When the 2020 data were compared with data from 2011–2019, hyphema showed the largest decrease (47.24%) in incidence among all ocular traumas, reaching significance in those ages less than 20 years (64.41%, P=0.004); the incidence of surgery for BOF also showed the largest decrease, in patients age less than 20 years. In the population age greater than or equal to 60 years, higher incidences of surgery for BOF and IOFB were observed (13.08% and 25.53%, respectively). CONCLUSIONS: While the incidence of closed-globe injuries has decreased over the past 10 years in age groups less than 60 years, those age with more than 60 years have become more prone to serious ocular trauma. During the COVID-19 era, the incidence of closed-globe injuries fell markedly in patients younger than 20 years of the age, possibly due to social distancing which involved school closures and reduction in outdoor activities.