Comments: Closed globe injuries in youth: A different approach to enhance global understanding of the issue.

Dear Editor,

Blunt ocular trauma is a common but underestimated public health problem causing blindness and visual impairment worldwide.[1] Identifying local or regional prevalence is difficult, since just some countries have trauma registries.[2] To bypass this issue, researchers carry out mostly retrospective studies using discharge, administrative, or medical records. However, these designs have several limitations including that follow-ups tend to be short, hindering long-term outcomes.[2]

Studies analyzing the epidemiology of ocular trauma can help reduce its psychological, economic, and social repercussions, morbidity, and healthcare expenses.[3] The article by Dr. Shah et al., “A prospective cohort study on the epidemiology of ocular trauma associated with closed-globe injuries in the pediatric age group”, sets the case for the magnitude of the issue and most importantly, highlights the use of a prospective design to study the situation.

This work is an essential contribution to understand close globe injuries and an incentive to reproduce the method globally. It also describes healthcare indicators not described before in medical literature. However, some details are missing: Firstly, it is unclear the number and characteristics of hospital/clinics and patients‘ sociodemographic data such as ethnicity, education, household income, etc. As readers in a different continent, it will be good to know more about the context for future comparisons. Secondly, injuries were described by their mechanisms but not by their intentionality.[3] An important aspect of research in injuries is to know if the events were intentional or not towards prevention strategies.[4] Finally, the authors described binomial regression analysis to identify predictors of a visual outcome set at >20/60 but those results are missing.[2] This could be a paperwork error when reviewing the manuscript; nevertheless, the relevance of this information urges us to write this letter in an attempt to identify those factors for future studies and the design of potential public health interventions.

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Conflicts of interest

There are no conflicts of interest.