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

BACKGROUND

Equestrian activities pose significant risks for ocular and ocular adnexal injuries, particularly from horse kicks and falls from horse riding.

OBJECTIVE

This study characterizes the spectrum of horse-related ocular trauma, analyzes outcomes, and provides recommendations for management of these injuries.

METHODS

A retrospective review was conducted at a large academic medical institution in the southeastern U.S. using ICD codes to identify horse-related ocular trauma cases. Demographics, injury mechanisms, clinical presentation, treatment, and long-term sequelae were analyzed.

RESULTS

Fifty patients (34 males, 16 females; mean age 37 years) sustained 73 ocular injuries. The most common mechanism was a horse kick (50%), followed by falls from a horse (28%). Orbital fractures (58%) were most frequent, followed by eyelid/periocular lacerations (16%), traumatic optic neuropathy (5%), corneal abrasions (5%), and open globe injuries (3%). Globe injuries were more associated with horse kicks than with falls from a horse.

CONCLUSIONS

Horse-related ocular trauma frequently involves severe injuries with a high rate of surgical intervention and long-term complications. Emergency providers should have a high suspicion for ocular injuries in midface trauma, particularly from horse kicks. Improved education, helmet use, and protective gear may help mitigate these risks.