EyeCon 2025: Alison Bozung, OD, FAAO, offers advice for managing ocular trauma

Alison Bozung, OD, FAAO, from Bascom Palmer Eye Institute, and who primarily works in the 24/7 ophthalmic emergency room, offered a detailed overview of both anterior and posterior segment injuries and shared insights relevant for optometrists who may encounter trauma in various practice settings. She presented alongside Thomas Albini, MD, on the topic of ocular trauma at the Optometry Times and Ophthalmology Times EyeCon 2025 conference, September 26 and 27 at the Margaritaville Hollywood Beach Resort in Hollywood, Florida.

Bozung emphasized the breadth of ocular trauma cases encountered in a tertiary care center: “A lot of the patients I'm seeing have more advanced trauma. So we get a lot of open globes, we do get intraocular foreign bodies, have a lot of orbital fractures.” She noted that the range of injuries seen includes routine cases such as corneal abrasions and subconjunctival hemorrhages as well as more severe presentations. Highlighting the variety, she said, “We also see things very routine, so corneal abrasions and scratches, subconjunctival hemorrhages that look scary but aren't, and kind of everything in between.”

One of the key advantages of working in a tertiary center is the availability of immediate interdisciplinary support. Bozung explained, “The great thing about it is that everyone's sort of in the same area, right? So if I need help from a retina surgeon, for example, I can just get on the phone and, and call a friend who's also there.” This facilitates timely referrals for cases requiring surgical intervention, such as orbital fractures or complex posterior segment injuries. She described her own scope of practice within trauma care: “As an optometrist, I handle everything that I can… anterior segment things, hyphema, traumatic iritis, corneal abrasions, those are pretty low hanging fruit to deal with. Other things, if there's a fracture that needs surgery, then I can obviously phone up a friend in oculoplastics.”

Bozung underscored the importance of on-the-job experience and strong foundational knowledge. “Having a really strong background in ocular disease and pathology and understanding how different parts of the eye work together is absolutely critical from a baseline standpoint,” she explained. Continuous exposure to a variety of trauma cases enhances diagnostic skill, particularly in recognizing subtle or atypical presentations: “Being able to see any red flags that might come up and being aware of what potential traumas may be more hidden or disguised, for example, is very important. Just having a keen eye for small details and never glossing over something that doesn't quite line up.”

For optometrists developing expertise in ocular trauma, Bozung offered practical advice: “Be ready to handle as much as you can and then know your limit of what you can do and what you need to get help on is also very critical too.” She emphasized the value of a reliable professional network for referrals and second opinions: “Having a good network of people that you can refer to or get second opinions if you need to is super important. So you don't feel like you're on an island by yourself treating all these crazy things.”

Overall, Bozung’s presentation highlighted the spectrum of ocular trauma seen in a tertiary care setting, the importance of collaborative practice, and the need for optometrists to develop both foundational knowledge and practical experience to manage these patients effectively.