SOAPBOX

SWOOPING SEASON A SERIOUS MATTER

BY THOMAS CAMPBELL

When I first moved to Victoria and began working as an eye doctor in the Royal Victorian Eye and Ear Hospital (RVEEH) Emergency Department, I was stunned by how often I saw patients with birdrelated eye injuries.

Intrigued, I searched the medical literature but was only able to find 89 reported cases of eye injuries caused by birds anywhere in the world. In contrast, a simple search of the Australian news revealed an enormous number of articles detailing bird-related eye injuries, including six recent potentially blinding events related to the aggressive territorial behaviour of the Australian magpie (Cracticus tibicen).

Public concern about bird attacks is so high in Australia that a website (www. magpiealert.com) has been launched specifically to provide information on bird attack hotspots in an attempt to warn pedestrians, runners, and cyclists of the risk. In 2019 alone, this website registered 3,799 attacks by birds in Australia – mostly magpies – of which 14.3% resulted in some kind of injury.

To explore the disconnect between the medical literature and on-theground reporting, my colleagues and I looked into how many people were affected by bird-related eye injuries at the RVEEH between 2012 and 2017. To our astonishment, we found that 287 people had suffered eye injuries caused by birds during that period – triple the total number of cases that had ever been reported in the literature across the world.

Fortunately, most people suffered only minor injuries, but a noteworthy minority (around 1–2%) suffered horrifying penetrating eye injuries. One of the worst series of cases happened last year in Sale, regional Victoria, when a rogue juvenile magpie attacked multiple people and inflicted serious injuries requiring emergency eye surgery. These cases were reported in this magazine at the time.

Although injuries of this severity are rare, they are potentially devastating. Several patients have required multiple, staged surgeries after the primary closure including lensectomies for capsular breach. Fortunately, most patients have eventually recovered good vision.

The magpie was the most common culprit of these attacks. More than a quarter of the RVEEH patients in our study explicitly identified the 2017 Australian Bird of the Year as their attacker, suggesting that the affection is not mutual. The other bird most commonly involved in such attacks was the pee-wee or mudlark (Grallina cyanoleuca). These two birds are similar in appearance, which raises the possibility of misidentification (in both directions).

One particularly interesting finding is that bird-related eye injuries are growing in frequency, with the number of injuries more than tripling between 2012 and 2017. This steady increase is also evident on magpiealert.com, where the number of self-reported attacks has grown over time. The reason for this is unclear, but one possibility is that urbanisation has led to a loss of natural nesting sites, resulting in an increase in inter-bird competition for nests and a corresponding increase in aggressive defensive behaviours.

Most of the attacks occur from May to October, with a peak in late September. This seasonal variation is significant as it allows for a targeted approach to public safety campaigns. The data suggests that local government authorities, schools, and businesses should begin bird-swooping safety campaigns in early winter and continue them through to early spring. One example of such a campaign can be found on the Victorian Government website, including a hotspot map of reported swooping birds and a list of the top 10 safety tips (https://www. wildlife.vic.gov.au/managing-wildlife/ swooping-birds).

Eyecare professionals should offer patients the following simple but effective advice: always wear a broadbrimmed hat and sunglasses when outside during swooping season.

If an aggressive bird makes someone its unwitting target, these everyday items will help to keep their eyes safe from roving beaks and claws. n

Name: Thomas Gordon Campbell Qualifications (in abbreviations): MBBS, DPhil (Oxon) Organisations: Centre for Eye Research Australia, the Royal Victorian Eye and Ear Hospital, and the NQ Eye Foundation Position: Fellow Location: Melbourne, Australia Years in the profession: 8 SEVERAL PATIENTS HAVE REQUIRED MULTIPLE, STAGED SURGERIES AFTER THE PRIMARY CLOSURE INCLUDING LENSECTOMIES.