INTRODUCTIONThe purpose of this study was to characterise and describe the epidemiology of all eye injuries presenting to the National University Hospital (NUH).

MATERIALS AND METHODSA prospective study was conducted over a 7-week period (11/4/2005 to 29/5/2005) on all ophthalmic trauma patients seen by the Department of Ophthalmology in NUH. Data on patient presentation, source of injury and intervention were collected via a standardised interview and examination, and documented using a validated datasheet.

RESULTSA total of 133 patients, and 139 eyes, were included in the study. The average age was 33.5 years, with a range of 5 years to 88 years, and 84.2% (n = 112) were men. Close to half (46.6%, n = 62) of the patients studied were non-Singaporeans. 56.4% (n = 75) of all eye injuries were work-related and only 5% (n = 7) of eyes were open-globe injuries. Common sources of eye trauma included: Use of high-powered tools in activities such as grinding, welding and hammering (38.3%, n = 51), human-inflicted injuries (12.0%, n =16) and road traffic accidents (8.3%, n = 11). Of the work-related eye injuries, 29.3% (n = 22) reported to having used personal protective equipment (PPE) at the time of injury, 38.7% (n = 29) had been issued PPE but had not used them, while 32% (n = 24) reported that PPE had not been issued. An initial visual acuity of 6/12 or better was found in 63.0% (n = 88) of patients and a reading of 6/60 or worse was found in 10.0% (n =14). Superficial foreign bodies (22.4%, n = 55) were the most common clinical finding, followed by periorbital bruise (12.2%, n = 30), lid ecchymoses (6.9%, n = 17), orbital fractures (6.5%, n = 16), lid laceration (6.1%, n = 15) and corneal abrasions (5.7%, n = 14).

CONCLUSIONThere is a broad spectrum of causes, mechanisms and severity of ophthalmic injuries seen in the hospital, of which work-related trauma makes up a significant proportion. The patients who suffer occupational injuries are a well-defined group: Young, non-Singaporean males, working with power tools in the construction industry are at particular risk. Although preventive strategies are in place for this high-risk group, the lack of awareness and compliance limit their effectiveness. The adequacy and functionality of PPE should be emphasised. In addition, preventive efforts are equally important in domestic, recreational, sports and transport settings. Eye trauma research and prevention can be further aided by a collaborative registry of eye injuries. A long-term islandwide database of all ophthalmic injuries is recommended.

Accident Prevention ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blindness ; epidemiology ; Child ; Child, Preschool ; Databases as Topic ; Eye Injuries ; epidemiology ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Prospective Studies ; Risk Assessment ; Risk Factors ; Singapore ; epidemiology

INTRODUCTION: We aimed to describe the clinical characteristics, diagnostic challenges, treatment patterns and outcomes of uveal melanoma (UM) in a tertiary care centre. METHODS: This is a retrospective case series of 11 consecutive patients with UM who were managed in a tertiary referral centre between 2002 and 2017. Epidemiological, clinical, pathological and radiological characteristics were reviewed. Classification of choroidal melanoma as small, medium or large was based on the criteria established by the Collaborative Ocular Melanoma Study. RESULTS: Mean age at presentation was 42.9 (range 27‒67) years. In 7 (64%) patients, a definitive diagnosis of UM was made after a mean follow-up period of 6.4 (range 1‒17) months. There were one, six and four patients with small-, medium- and large-sized choroidal melanomas, respectively. Treatment was enucleation in 5 (45.5%) patients, plaque brachytherapy in 4 (36.4%) patients, transpupillary thermotherapy in 1 (9.1%) patient, and observation in 1 (9.1%) patient. Median follow-up was 29 months. Metastatic disease developed in 5 (45.5%) patients at the mean age of 46.6 (range 38‒56) years, with median overall survival of 20 months. Genetic mutations in three patients were monosomy 3 (n = 2), and gain of 3q and 8q (n = 1). CONCLUSION Our study supports the finding that UM in Chinese and Asian Indian patients presents at a younger age than in Caucasians. Although it is rare, ophthalmologists should remain mindful of this life-threatening disease. We propose establishing a national and regional registry for ocular tumours with genetic information to characterise the disease spectrum in Southeast Asia.