Date of Award

January 2022

Document Type


Degree Name

Medical Doctor (MD)



First Advisor

Kristen Nwanyanwu

Second Advisor

Christopher Teng


Purpose: To investigate domestic violence-related ocular injuries among adult emergency department patients in the United States.

Methods: This was a retrospective, cross-sectional study of patients with a diagnosis of domestic violence and primary or secondary diagnosis of ocular injury in the Nationwide Emergency Department Sample (NEDS) from 2008-2017. We identified patient- and hospital-level variables associated with domestic violence-related ocular injuries. We calculated annual incidence rates using US Census data. Adjusting for inflation using the Consumer Price Index, we calculated mean and total charges.

Results: From 2008-2017, there were 26,215 emergency department visits related to domestic violence with an average incidence of 1.09 per 100,000 adult population (female patients, 84.5%; mean age [SE], 34.3 [0.2]). Domestic violence-related ocular injuries were most prevalent among patients in the lowest income quartile (39.1%) and on Medicaid (37.4%). Most emergency department visits presented to metropolitan teaching (55.4%), non-trauma (46.7%), and south regional (30.5%) hospitals. The most common ocular injury was contusion of eye/adnexa (61.1%). The hospital admission rate was 5.2% with a mean hospital stay of 2.9 [0.2]. Inflation-adjusted mean cost for medical services was $38,540 [2,310.8] with an average increase of $2,116 annually. The likelihood of hospital admission increased for patients aged ≥60 years old, on Medicare, and with a diagnosis of open globe or facial/orbital fractures (all p<0.05).

Conclusion: Contusion of the eye/adnexa was the most common ocular injury among patients with domestic violence-related emergency department visits. To better facilitate referrals to social services, ophthalmologists should target domestic violence screenings towards women and patients of less privileged socioeconomic status.


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