Authors' objectives: To determine whether there is any evidence to support the (causal) association between the development of cataracts in patients with traumatic brain injury (TBI) without any evidence of having orbital or ocular trauma.

Authors' results and conclusions: Overall, 85 published studies were identified from the literature searches. Upon examination on the titles and abstracts of these 85 studies, 11 studies were thought to be relevant and were retrieved in full for further appraisals. Three studies were added as the results of manual searches. As such, 14 studies were retrieved in full in this systematic review. Of the 14 studies that were retrieved in full, only one study provided data potentially relevant and is appraised further below. The other 13 studies either did not discuss relevant topic to this systematic review or did not provide any data that are relevant to the objective of this systematic review. A study, attempting to identify injury-related risk factors for secondary cataract incidence after eye and brain injury and poly-trauma in Service Members of US Armed Forces, employed data available from the Military Health System Management and Analysis Reporting Tool between 2017 and 2021 from inpatient and outpatient Service Members (level of evidence 3). In this database, the date of the first cataract diagnosis was tracked to estimate the annual incidence rate and it was then longitudinally linked to any prior diagnosis of ocular trauma (OT), traumatic brain injury (TBI) or polytrauma in order to calculate the annual incidence rate. International Classification of Disease codes, 9th revision and 10th Revision (ICD-9 and ICD-10) were employed to identify the patients with the diagnoses of cataracts, polytrauma, TBI, and OT. To this date, this study was the only study providing data on the potential association between having TBI and developing cataracts. Although this study provided data on the strength of the association, other criteria on assessing causal association, such as consistency, specificity, dose-response and biological plausibility have not been fulfilled. At present, there is one study showing potential association between having cataracts in patient with TBI in the absence of orbital/ocular trauma. However, this evidence has to be interpreted with caution as bias and confounding may affect the reported outcomes. With regard to assessing the potential causal association between TBI without ocular/orbital trauma and the development of cataracts, at present, there is not enough evidence to assess such a causal association.

Authors' methods: A comprehensive and systematic literature search was conducted on April 7, 2025. The search was done on commercial medical literature databases. Combination of keywords was employed in this literature search. No limitation, such as on the language or date of publication, was implemented in any of these literature searches. A manual search was also conducted on the references of the articles that were retrieved in full. From the above search, one relevant study was identified and retrieved in full. Due to the scarcity of studies that were identified from the above search relevant to the objective of this systematic review, we then employed a unique “similar article” algorithm available in PubMed to expand the literature search. No limitation, such as on the language or date of publication, was implemented in any of these literature searches. A manual search was also conducted on the references of the articles that were retrieved in full.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2025

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/tbi-without-any-ocular-trauma-cataract-development?lang=en&origin=s&returnurl=https%3A%2F%2Fwww.worksafebc.com%2Fen%2Fforms-resources%23sort%3DDate%26q%3DTraumatic%2520Brain%2520Injury%2520(TBI)%2520Without%2520Any%2520Ocular%2520Trauma%2520and%2520Cataract%2520Development%26f%3Alanguage-facet%3D%5BEnglish%5D%26tags%3DGuide%7C2d7eb4b30f6a4a319e0d40565c9abbab%2CHealth%2520Care%2520Provider%7C13468b0b3f074f6bade3f57ac3cdfb8e%2CSystematic%2520Review%7Cf78c29d570c14ec3b5a394385905df70&highlight=Traumatic%20Brain%20Injury%20(TBI)%20Without%20Any%20Ocular%20Trauma%20and%20Cataract%20Development

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

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