Lawnmower-Related Eye Injuries in the U.S. 2004-2023.

OBJECTIVE To determine the epidemiology, mechanisms, and trends of lawnmower-related eye injuries in the U.S., focusing on national estimates, injury types, and high-risk populations. DESIGN A retrospective trend study. PARTICIPANTS Individuals presenting to National Electronic Injury Surveillance System (NEISS) emergency departments. METHODS Lawnmower-related eye injuries from 2004-2023 were identified using the NEISS. The database narratives were coded to classify the mechanism of injury and other variables. Periorbital injuries were not included. Descriptive and comparative analyses (chi-square and Fisher's exact test) were performed of national estimates derived using statistical weights. MAIN OUTCOME MEASURES Injury mechanisms, demographics, diagnoses, and trends over time. RESULTS An estimated 120,613 lawnmower-related eye injuries occurred in the U.S. from 2004-2023 (N=2,467 NEISS cases). Those injured were 82% males, 95% adults and 82% non-Hispanic Whites. Ninety-nine percent of injuries occurred at home. Most injuries (77%) were from projectiles (predominately grass, dirt and rocks), 12% non-projectile injuries during mowing, 8% maintenance/repair-related and 2% from chemical exposures (primarily gasoline). Common diagnoses included eye abrasions/contusions (55%) and foreign bodies (27%). Severe injuries included retinal detachment, iris sphincter tear, corneal erosion, lens dislocation, and open globes. Only 2% of projectile injuries were documented in narratives as using eye protection including eyeglasses. The average annual estimate for lawnmower-related eye injuries was 33% lower when comparing 2018-2023 to 2004-2017 (4,502 vs. 6,686, p<0.001). Injuries decreased more in males than in females (35% vs. 23%, p<0.001), and in adults aged 18-65 (35%) as compared to youth <18 yrs (26%) and adults >65 yrs (23%), p<0.001. Whereas injuries decreased in non-Hispanic White individuals (41%), they increased in Black individuals (18%) and other racial/ethnic groups including Hispanic (42%), p<0.001. Youth <18 years were a higher proportion of bystander (50%) versus operator (5%) injuries, p<0.001. Bystanders, as compared to operators, had higher rates of severe injuries requiring hospital admission, p=0.002. CONCLUSIONS Lawnmower-related eye injuries remain a serious risk, especially from projectiles. Interventions designed to increase the use of safety glasses both while operating mowers and when performing maintenance/repair such as sharpening blades and prevent bystander presence, especially children, are needed to significantly reduce risk of injury.