Horsing Around: A Retrospective Study of Equestrian Related Eye Injuries in the Emergency Department.

Overview

• This study examines eye injuries caused by horses, focusing on the types of injuries, how they happen, patient outcomes, and recommendations for treatment and prevention.

Background and Objective

• Equestrian activities, such as horse riding and handling, pose significant risks for eye and surrounding tissue injuries.
• Such injuries often result from horse kicks or falls associated with riding.
• The study aims to characterize the variety (spectrum) of these horse-related ocular (eye) trauma cases and analyze their outcomes.
• Researchers also seek to provide practical recommendations for managing and preventing these injuries in the emergency care setting.

Methods

• A retrospective review was conducted, which means that researchers looked back at past medical records.
• The study was performed at a large academic medical center in the southeastern United States.
• Cases of horse-related eye injuries were identified using International Classification of Diseases (ICD) codes linking the event to ocular trauma.
• Researchers collected data on:
  • Patient demographics (age, sex)
  • Mechanism of injury (e.g., horse kick, fall from horse)
  • Clinical presentation (types of injuries observed)
  • Treatment given (including surgical intervention)
  • Long-term consequences or sequelae after the injury

Results

• Total number of patients: 50 (34 males, 16 females)
• Mean patient age: 37 years
• Total ocular injuries documented: 73 injuries among 50 patients, indicating some patients had multiple injuries.
• Mechanisms of injury:
  • Horse kicks accounted for 50% of injuries
  • Falls from horses accounted for 28%
  • Other causes less common or unspecified in this abstract
• Types of injuries:
  • Orbital fractures (fractures of the bones around the eye) were the most frequent at 58%
  • Eyelid or periocular lacerations (cuts around the eye area) – 16%
  • Traumatic optic neuropathy (damage to the optic nerve causing vision issues) – 5%
  • Corneal abrasions (scratches on the clear front surface of the eye) – 5%
  • Open globe injuries (penetration or rupture of the eyeball) – 3%
• Correlation noted:
  • Open globe injuries were more frequently caused by horse kicks than by falls.

Conclusions and Recommendations

• Horse-related eye injuries tend to be severe, often requiring surgical intervention.
• There is a high risk of long-term complications and vision problems after such injuries.
• Emergency healthcare providers should maintain a high index of suspicion for eye injuries when treating midface trauma, particularly when caused by a horse kick.
• Preventive measures emphasized in the study include:
  • Improving education about risks involved in horse handling and riding
  • Increasing the use of helmets designed to protect the eye and surrounding areas
  • Adopting protective gear to reduce injury severity