Incidence of Open Globe Injury and Associations with Concomitant Ocular Injury and Surgical Intervention in a Nationwide U.S. Cohort

To (1) characterize open‑globe injury (OGI) incidence and (2) evaluate associations between OGI, concomitant ocular injury, and timing of surgical intervention. Using a multi-institutional electronic health record platform, we estimated OGI incidence per 100,000 person-years, overall and seasonally, from 2016 to 2024. We also calculated the relative risk (RR) of concomitant ocular injuries and surgical interventions between patients with and without OGI. Surgical interventions were stratified at 1, 3, 6 months, and 1 year. Propensity score matching was performed on demographic variables. Sensitivity analysis applied outcome-specific exclusion and matching criteria. OGI incidence ranged from 11–16 per 100,000 person-years and rose sharply from 2022 to 2024, with the highest incidence in summer. In our most rigorous analyses, compared with patients without OGI (n = 6,016,338), those with OGI (n = 28,679) had a significantly higher risk of traumatic cataract (RR 107.53, 95%CI 60.92–189.80), hyphema (RR 25.32, 95%CI 19.48–32.91), and choroidal hemorrhage/rupture/detachment (RR 31.39, 95%CI 20.12–48.98). When comparing OGI with those without OGI, the RR was highest for vitrectomy and retinal detachment repair acutely (1–3 months after OGI), and the RR for lacrimal repair and corneal surgery increased over time (6 months–1 year after OGI). OGI incidence is highest in summer and confers a markedly increased risk for ocular comorbidities and surgical interventions. These findings underscore the need for timely repair and long-term surveillance and inform resource planning in ophthalmic trauma care.