key: cord-0870788-txwcpgd7
authors: Chen, Haoyu; Jhanji, Vishal; Agrawal, Rupesh; Yan, Hua
title: Editorial: Updates on Ocular Trauma
date: 2022-04-28
journal: Front Med (Lausanne)
DOI: 10.3389/fmed.2022.906253
sha: d159d6c7087c2e0e1e5cc170039c6b726d550271
doc_id: 870788
cord_uid: txwcpgd7

nan

Ocular trauma is a significant cause of visual impairment worldwide. It is estimated that 19 million people worldwide have uniocular blindness from traumatic injury (1) . Severe ocular trauma remains a challenge for physicians and may cause permanent blindness and even the loss of an eyeball. As ocular trauma refers exclusively to globe trauma, the use of the term "ophthalmic trauma" has been recommended to involve globe, adnexal, and orbital trauma. Recently, advances in research and data analytics have promoted our understanding and management of ocular trauma. Molecular biology of human tissues and animal models have revealed inflammation with unique molecular pathways in the pathogenesis of various types of ocular trauma (2) . The application of in vivo imaging techniques, such as optical coherence tomography (3) and adaptive optics laser scanning ophthalmoscopy, has also helped us better understand the mechanism of damage to ocular tissues by external injuries. The advances of microinvasive vitrectomy, other surgical techniques, and novel surgical materials have improved the outcome of ocular trauma. The International Globe and Adnexal Trauma Epidemiology Study (IGATES) registry has furthered the research in ophthalmic trauma by facilitating global collaboration through a secure web-based platform for capturing both prospective and retrospective data by asking critical questions in patients with an eye injury (4) . Novel tools such as the Ophthalmic Trauma Correlation Matrix (OTCM) have been proposed and evaluated for better management of patients with open globe injury (5) . The Research Topic, Updates on Ocular Trauma, brings readers up-to-date laboratory, imaging, clinical, and epidemiological research on advances in ocular trauma.

An animal model would provide insight into the pathogenesis of ocular trauma and the development of potential treatment. Liu et al. established a new rabbit model of closed globe blast injury using a self-developed gas shock device. The equipment had a high-pressure air compression pump and could deliver different blast pressures of gas to the eyes. They found corneal edema, anterior chamber hyphema, lens opacity, vitreous hemorrhage, commotio retinae, and retinal ganglion cell damage in rabbit eyes with gas shock. Moreover, the severity of injury depended on the pressure. This rabbit model nicely replicates clinical closed globe injury.

Epidemiological studies can identify the prevalence and risk factors of ocular trauma, which would help to develop preventive strategies. Zhang et al. investigated the epidemiology of sportsrelated eye injuries among athletes. They found that 10.7% of athletes had a history of sports-related eye injury. Handball, water polo, and diving were the top types of sports that injured the eyes. Balls and teammates are both important sources of eye injury. An adnexa wound was the most common type of injury. About 11.9% of the eye injuries resulted in impaired visual acuity. The risk factors for eye injury included <18 years old, lower family income, and training > 4 h a day.

Yu et al. reviewed the prevalence, spectrum, and management strategies of ocular trauma during the COVID-19 pandemic. They found that the prevalence of eye trauma decreased with a trend of delayed treatment during the COVID-19 pandemic. The possible mechanism may be irregular epidemic prevention and control measures, unprotected home activities, and unusual mental states. They discussed several strategies targeting these mechanisms for the prevention of eye injury during the COVID-19 pandemic.

Analysis of clinical spectrum and outcomes would benefit our understanding of ocular injury. Chen et al. analyzed 622 adult patients with light perception or no light perception after open globe injury. They found that 8.5% of the eyes received primary evisceration because of no possible anatomical reconstruction. There were 239 eyes that received vitreoretinal surgery. Over the 6-month follow-up, 21.9% of eyes were eviscerated, 24.0% atrophied, only 21.1% had some visual acuity, and 8.5% had vision better than 0.3. In Chen's other study of pediatric open globe injury, they found the most common injury type was penetration (89%). Scissors, knives, pens, and wood were common causes. Most (76.1%) of the injuries were in zone 1. In general, the articles on this Research Topic and current advancements in the field of ophthalmic trauma have provided updated information on the animal model, incidence, risk factors, clinical spectrum, precise diagnosis, intervention, and prognosis of a patient with an eye injury. There are some potential difficulties in the research of ocular trauma. There is a lack of large sample size high-quality datasets with long-time followup. It is not easy to conduct randomized control trials because of highly heterogenous clinical characteristics. Multicenter, even multinational collaboration is needed to collect large sample size, high-quality data and conduct randomized control trials to provide higher-level evidence for clinical decisions (4). The secure web-based global all-encompassing registries like IGATES, can provide real-time pooled data analysis that will not only advance our understanding in the field of ophthalmic trauma but also help us with predictive modeling and novel tools for evidence-based counseling of a trauma victim (4).

The global impact of eye injuries

Activated blood coagulation factor X (FXa) contributes to the development of traumatic PVR through promoting RPE epithelial-mesenchymal transition

Prediction of spontaneous closure of traumatic macular hole with spectral domain optical coherence tomography

The application of clinical registries in ophthalmic trauma-the International Globe and Adnexal Trauma Epidemiology Study (IGATES)

Ophthalmic Trauma Correlation Matrix (OTCM): a potential novel tool for evaluation of concomitant ocular tissue damage in open globe injuries

HC and HY conceived the idea. RA and VJ critically reviewed the manuscript and revised the article. All authors contributed to the article and approved the submitted version. 

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.Publisher's Note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.Copyright © 2022 Chen, Jhanji, Agrawal and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.