Ocular Trauma From Dog Bites: Characterization, Associations, and Treatment Patterns at a Regional Level I Trauma Center Over 11 Years

June 2015 | By Mark A. Prendes, MD, Arash Jian-Amadi, MD, Shu-Hong Chang, MD and Solomon S. Shaftel, MD, PhD

A retrospective review of 342 dog bite victims from 2003 to 2013 from Harborview Medical Center, a regional level 1 trauma center in the Northwest. Pit bulls accounted for more than 1 in 4 injuries.

Study highlights

  • 342 patients who sustained dog bite injuries between 2003 and 2013 were identified in the Harborview Medical Center trauma registry using E-code 906.0. The pit bull was the canine breed most associated with dog bite injuries in the trauma registry, documented as being responsible in more than 1 of 4 injuries (27%). Among dogs unknown to patients (stranger), pit bulls were responsible for 60% of these injuries.
  • The data set was then divided into patients sustaining or not-sustaining ocular injuries. Ninety-one patients (27%) sustained ocular injuries, while 251 (73%) did not. Small children represented most of the ocular injuries with 68% being younger than 10 years. Pit bulls were again responsible for 1 in 4 ocular injuries (25%). Among dogs unknown to patients (stranger), pit bulls were responsible for 63% of these injuries.
  • This study is the first to accurately establish that pit bulls are the breed most commonly associated with ocular injuries (25%). Most alarming is the observation that when attacks come from unfamiliar dogs, the pit bull was responsible for 60% and 63% of all injuries and ocular injuries, respectively.
  • This study firmly establishes previous observations that children are disproportionately affected by ocular trauma from dog bites. The authors found a 4.2-fold higher rate of ocular injuries in children as compared with adults (45.2% vs. 10.8%). Furthermore, 69% of ocular injuries were in children younger than 10 years. This finding is consistent with prior studies, which demonstrate that younger children are more likely to suffer dog bites to the face and scalp.
  • Other breeds commonly identified in ocular injuries were mixed (19%) and labrador retrievers (10%). Less frequently involved were the rottweiler (3%), German shepherd (3%), mastiff (3%), doberman (3%), and golden retriever breeds (3%). The dogs responsible for the ocular injuries were related to the patients most often as a personal, friends, or neighbor’s pet.
  • The current study provides strong evidence that pit bulls are indeed highly aggressive, albeit unknown whether by nature or nurture, and are in fact the most common culprits of serious pediatric ocular injuries. The authors hope these data can help guide awareness and help shape public policy to increase the safety and well being of children.
Ocular Trauma From Dog Bites: Characterization, Associations, and Treatment Patterns at a Regional Level I Trauma Center Over 11 Years, by Prendes MA, Jian-Amadi A, Chang SH and Shaftel SS, Ophthalmic Plastic and Reconstructive Surgery, June 2015, [Epub ahead of print].