Ocular trauma is a leading cause of preventable monocular blindness worldwide and imposes significant socioeconomic burdens. This study aims to describe the demographic patterns, trauma profiles, mechanisms of injury, and spectrum of ocular injuries across Malaysia's Ministry of Health (MOH) ophthalmology services.

We prospectively collected data from MOH facilities with ophthalmology services on patient demographics, trauma profiles, mechanisms of injury, baseline eye assessment, use of eye protection, foreign bodies, and details of patients with various ocular injuries. The spectrum of ocular injuries was classified as trivial or severe based on presenting visual acuity, further complications, the need for surgical intervention, frequent follow-up, and ward admission.

A total of 2,347 ocular trauma cases were reported across six regions in Malaysia. Ocular trauma predominantly affected males (over 80%), with a mean age of approximately 35 years. Workplace injuries were the most common in trivial cases (36.0%), while domestic injuries were more frequently associated with severe cases (30.3%). Most injuries were accidental, often involving metallic or sharp objects. The use of eye protection was low, at 13.1% in trivial cases and 5.5% in severe cases. Severe injuries were significantly associated with poorer initial visual acuity, relative afferent pupillary defect (RAPD), and higher likelihood of requiring surgery (55.5%). Common presentations included corneal foreign bodies (trivial) and lid lacerations, full-thickness corneal wounds, and orbital fractures (severe).

This first nationwide study of ocular trauma in Malaysia identifies key risk groups and injury patterns, highlighting needs for focused public health interventions. These findings support the creation of a national ocular trauma registry and reinforce the importance of public education and occupational eye safety measures for preventable vision loss. However, these findings need to be interpreted cautiously, as private hospital cases were not included, and our findings may not reflect the whole picture.