AIM: To evaluate the prevalence of early post-traumatic stress disorder (PTSD) among young and middle-aged patients who have suffered open globe injuries, and to identify the psychosocial factors influencing PTSD in these patients. METHODS: A total of 280 patients who underwent ocular trauma surgery between January 2023 and January 2024 were selected through convenience sampling. Data were collected using a custom-designed demographic questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), the Cognitive Emotion Regulation Questionnaire (C-ERRI), and the PTSD Checklist-Civilian Version (PCL-C). Univariate analysis and stepwise multiple linear regression analysis were performed to determine the factors affecting PTSD in these patients. RESULTS: The average PTSD score for the patients was 33.22±13.48. The scores for individual PTSD dimensions, ranked from highest to lowest, were recurrent traumatic experiences, heightened arousal, avoidance reactions, and social dysfunction. Positive PTSD symptoms were observed in 85 patients (30.36%). Univariate analysis indicated that gender, postoperative vision, marital status, psychological resilience, and rumination were significant factors affecting PTSD symptoms (χ²/t=6.53, 17.88, 8.83, 2.17, and 14.1, respectively; all P<0.05). Pearson correlation analysis showed a positive correlation between rumination and PTSD symptoms (r=0.73, P<0.01) and a negative correlation between psychological resilience and PTSD symptoms (r= -0.14, P<0.05). Stepwise multiple linear regression analysis identified postoperative vision (notably eye removal), rumination levels, and psychological resilience (optimism) as major factors influencing PTSD in these patients (R²=0.57, P<0.001). CONCLUSION: Young and middle-aged patients with open globe injuries have a high incidence of PTSD. Significant risk factors for early PTSD include primary enucleation, high levels of rumination, and low psychological resilience (optimism). Conversely, patients with good postoperative vision recovery, low rumination levels, and high levels of optimism are less likely to develop PTSD. Healthcare providers should pay special attention to patients who undergo primary enucleation, strive to reduce their rumination levels, and enhance their psychological resilience, thereby promoting a positive and optimistic attitude towards their condition and reducing the incidence of PTSD.