Vol. 7, Issue 2, Part A (2025)

Aim: To review the epidemiology, aetiology, and surgical outcomes of ocular trauma requiring surgical intervention in Indigenous populations in Australia from January 2010 to June 2025, highlighting implications for rural and remote communities. Methods: A systematic review was conducted using PubMed, Embase, and MEDLINE, identifying studies on ocular trauma in Indigenous Australians. Studies were included if they reported on epidemiology, aetiology, or surgical outcomes (visual acuity [VA] or complications). Data was synthesised to describe injury patterns, surgical interventions, and outcomes. Results: Seven studies met inclusion criteria, covering 688 Indigenous cases requiring surgery across Far North Queensland (FNQ), Northern Territory (NT) and Western Australia (WA). Indigenous patients accounted for 19.6–29.2% of ocular trauma cases, despite their lower proportion in the general population. Mean age was 35.2 years (range: 2–81), with 83.6% male predominance. Open globe injuries (OGI) accounted for 43.5% (penetrating 48.2–51.6%, rupture 35.9–36.5%, intraocular foreign body [IOFB] 12.5–15.3%), and closed globe injuries (CGI) 56.5% (contusion 52.8–53.7%, lamellar laceration 25.9–28.3%). Assaults (45%) and alcohol-related injuries (46.3%) were leading causes. Surgical intervention occurred in 56.8% of cases, with 90–92.3% within 24 hours. Mean presenting VA was LogMAR 1.49 (6/180 Snellen), improving to LogMAR 0.86 (6/36, p<0.001). Complications included endophthalmitis (6.2%) and retinal detachment (4.3%). Alcohol restrictions in FNQ reduced alcohol-related injuries by 20.1% (p<0.01). Conclusion: This first systematic review of ocular trauma in Indigenous Australians highlights a high burden of OGI and alcohol-related injuries, with significant VA improvement post-surgery. Targeted prevention, including alcohol harm reduction and improved rural healthcare access, is critical to address disparities.