The Impact of Ocular Trauma on Psychological Distress and Quality of Life Amidst the 2023-2025 Gaza War

Abstract Introduction: The Gaza war has resulted in substantial civilian ocular trauma resulting in psychological and functional consequences. The study aimed to quantify the severity of the ocular injury and examine its association with depression, anxiety, and vision-related quality of life (QoL) among the survivors between October 2023 and January 2025. Methods This cross-sectional study enrolled 375 ocular trauma patients across all five Gaza governorates. Visual acuity was recorded in logMAR and severity was classified by the Ocular Trauma Score (OTS). Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS), and vision-related QoL using the NEI-VFQ-25. Results Participants were predominantly male (72.5%) with mean age 37 ± 15 years. Open-globe injuries predominated (73.3%), followed by retinal detachment (61.8%) and globe rupture (43.0%). Depression and anxiety met case criteria in 56.5% and 30.1% of the participants, respectively. Visual acuity differed significantly across depression (p = 0.008) and anxiety (p = 0.002) categories, and OTS distributions differed across both (both p < 0.001). Higher OTS scores correlated with lower depression (ρ = −0.253), lower anxiety (ρ = −0.220), and higher QoL (ρ = 0.142; all p < 0.01). In adjusted multivariable models, OTS independently predicted depression (B = − 0.924), anxiety (B = − 0.983), and QoL (B = 1.763; all p < 0.001). Conclusion Ocular trauma severity is independently associated with greater psychological distress and lower vision-related QoL among civilians injured during the Gaza war. Integrated ophthalmic and mental-health care should be prioritized in conflict-zone health responses.