Ocular injuries caused by Japanese black bears: a 10-year retrospective analysis of severity and clinical outcomes.

Background: Although bear-related injuries are increasing in Japan, ocular trauma associated with Japanese black bear ( Methods: Eight patients who were transported to Fukushima Medical University Hospital for bear-related trauma and subsequently referred to the Department of Ophthalmology for periocular injuries between April 2016 and March 2026 were retrospectively reviewed. Patient demographics, location of injury, the presence of globe rupture, extraocular muscle laceration, eyelid laceration, and facial bone fracture, as well as final best-corrected visual acuity, were evaluated. Results: Eight patients (mean age 66.6 ± 20.4 years; seven men and one woman) were included. All patients sustained eyelid lacerations. Open globe injury was observed in four eyes (50%), all classified as rupture. Three were surgically confirmed, and one was diagnosed based on clinical and CT findings without surgical exploration. Three of the four globe ruptures (75%) occurred in mountainous areas, and the remaining case in a rural settlement. Half of the cases (4/8) occurred during the most recent two years (2024-2025). Conclusion: Among bear-related ocular injuries referred to our department over the past 10 years, half involved globe rupture, with the majority occurring in mountainous areas. As bear-related trauma may continue to increase in northern Japan, the establishment of regional management protocols and multidisciplinary collaboration is warranted.