preprint · medRxiv
A cross-sectional study of 383 adult patients admitted with head trauma to the emergency department of Mulago National Referral Hospital in Kampala, Uganda, evaluated the frequency and risk factors of co-occurring eye injuries. Ocular injury was diagnosed in 70.0 percent of the patients. Analysis revealed that patients aged 26 to 44 years, commercial motorcyclists (boda-boda riders), individuals involved in road traffic accidents, those with severe head injuries, and those with facial fractures experienced a significantly higher likelihood of ocular involvement. In contrast, intracranial haemorrhagic lesions were inversely associated with ocular damage. The findings demonstrate that ocular injuries are highly prevalent in head trauma cases, indicating that emergency clinical protocols should prioritise standardised ophthalmic assessments for high-risk patients to curb preventable visual impairment.
Head trauma often leads to accompanying eye injuries that risk causing permanent visual impairment if not promptly diagnosed. Identifying high-risk patient profiles, such as commercial motorcyclists and individuals with facial fractures, allows emergency medical teams to rapidly prioritise dedicated ophthalmic evaluations. This targeted approach supports timely clinical intervention and better resource allocation in busy hospital emergency departments.
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Abstract Background Given the close anatomical proximity of the eye and its adnexae to the cranium, ocular injury frequently coexists with head trauma. However, specific factors predisposing patients with head injury to ocular involvement in Uganda remain poorly defined. Objective This study aimed to determine the factors associated with ocular injury among patients with head injury at Mulago National Referral Hospital (MNRH), a tertiary referral facility in Kampala, Uganda. Methods We conducted a cross-sectional study among 383 adult patients admitted with head injury to the Accidents and Emergency Department of MNRH from 15/05/2025 to 30/07/2025. All participants underwent a standardized ophthalmic evaluation. Bivariable and multivariable Poisson regression analyses were used to identify factors associated with ocular injury, reported as adjusted prevalence ratios (APR). Results Ocular injury was identified in 268 of 383 patients (70.0%; 95% CI: 65.1-74.5). On multivariable analysis, age 26-44 years (APR 1.18; 95% CI: 1.11-1.43; p=0.013), commercial motorcyclist (boda-boda rider) occupation (APR 1.25; 95% CI: 1.06-1.47; p=0.007), road traffic accident mechanism of injury (APR 1.19; 95% CI: 1.02-1.38; p=0.03), severe head injury (APR 1.70; 95% CI: 1.44-2.01; p<0.0001), and the presence of facial fractures (APR 1.61; 95% CI : 1.44-1.81; p<0.0001) significantly increased the likelihood of ocular injury. Conversely, intracranial hemorrhagic lesions were inversely associated with ocular injury (APR 0.80; 95% CI: 0.68-0.93; p=0.004). Conclusion Ocular injuries are common among patients with head injury. Patients aged 26 to 44 years, commercial motorcyclist occupation, road traffic injury, severe head injury, and facial fractures have a higher risk of ocular injury. We recommend prioritizing ophthalmic evaluation of for patients admitted with head injury to minimize preventable visual impairment.
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DOI: 10.64898/2026.08.18.26360753
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