Visual prognosis following open globe injury: clinical characteristics and risk factors from Vietnam National Eye Hospital

To evaluate the clinical characteristics and risk factors associated with visual prognosis in patients with open globe injuries (OGIs) treated at Vietnam National Eye Hospital.

A prospective observational study included patients with OGIs treated between June 2023 and June 2024. Data on demographics, injury features, and clinical findings were extracted from medical records. Poor visual outcome was defined as final best-corrected visual acuity (BCVA) worse than 20/400 or no light perception. Multivariable logistic regression was performed to identify independent risk factors.

Among 509 patients (636 eyes), the mean age was 35.13y (range 20–51y), and 67.6% were male. After treatment, the proportion of eyes achieving ≥20/40 increased from 12.6% to 42.1%, while no light perception decreased from 29.1% to 9.4%. Independent predictors of poor visual outcomes included delayed admission [>4h, odds ratio (OR)=3.33, 95% confidence intervals (CI): 1.76–6.33, P<0.001], Zone Ⅲ injury (OR=5.90, 95%CI: 2.85–12.24, P<0.001), wound length >10 mm (OR=2.59, 95%CI: 1.60–4.18, P<0.001), relative afferent pupillary defect (RAPD, OR=1.65, 95%CI: 1.03–2.64, P=0.039), endophthalmitis (OR=1.75, 95%CI: 1.01–3.03, P=0.047), retinal detachment (OR=3.32, 95%CI: 2.02–5.45, P<0.001), and eyelid lacerations (OR=1.94, 95%CI: 1.13–3.33, P=0.016) associated with OGIs. Vitreous hemorrhage (OR=0.44, 95%CI: 0.22–0.89, P=0.023) was associated with better outcomes, and female gender appeared protective.

Poor visual outcomes remain common after OGIs, despite improve visual acuity in many cases. Several clinical and injury-related factors are strongly associated with prognosis. Early recognition of these predictors can support risk stratification and improve trauma care in similar settings.