Blunt ocular trauma in patients over 70: Clinical characteristics and prognosis

Abstract

Purpose: To describe the mechanisms and outcomes of open globe injuries (OGIs) in patients 70 years or older. Methods: A retrospective chart review of patients from two large academic centers in Israel who were underwent surgery for OGI. Data was collected from surgical and clinic charts. Anatomical and functional results were recorded as well any additional surgeries and complications. Results: Thirty-two eyes of 32 patients were included. The mechanism of OGI consisted of blunt trauma with ocular rupture secondary to falls. All eyes underwent immediate primary closure of the corneal and scleral lacerations. Additional surgeries were performed in 34.3% of cases. In 31.2% of cases additional surgery was not required, and in 21.9% of cases the damage was so devastating that additional procedures were not recommended. Four patients (12.5%) chose not to undergo additional surgery. Mean visual acuity at presentation was 2.24 ± 0.72 logMAR and it improved to 1.92 ± 0.89 logMAR at final follow-up ( p = 0.002). VA at presentation was significantly correlated to final VA ( p < 0.001). Conclusions: OGI in the elderly represents a unique group. It is mostly related to falls, with a female predominance and a poor visual prognosis. In this patient population, general health concerns and increased risks of anesthesia require special attention. Care should be taken to educate elderly patients and their caretakers on how to avoid falls.

Clinical Review of Ocular Traumas Resulting in Enucleation or Evisceration in a Tertiary Eye Care Center in Hungary

“…Male predominance at younger age may be associated with occupational exposure and risk-taking behavior (higher incidence of assault, sport, and traffic accident-related ocular injuries) [ 15 ]. However, a change in male/female proportion was observable in older ages, as we found a female predominance (69.2%) in people older than 70 years, similar to the study by Vidne-Hay et al [ 16 ], which may be related to the suggestion that elderly women with osteoporosis have an increased risk of falling and sustaining injuries [ 17 ].…”

Fall-related ocular trauma in patients over 90 years in tertiary ophthalmic center in Germany: 90-TOSG Report 1

“…However, fall-related eye trauma is more common in women [ 3 , 9 , 10 ]. In studies conducted on patients over the age of 65 years, women comprise 60–65% of the patients with open globe injuries due to falls [ 3 , 5 ]. In the present study, 82% of the patients were female.…”

“…9% of patients over the 70 years of age with fall-related OGR had no light perception at presentation [ 5 ]. This rate has been reported to be 24% in all types of open globe trauma [ 4 ].…”

“…Falls are the most common cause of eye injury in this population [ 4 ]. The frequency of eye trauma in falls and vision-threatening complications increases also with older age and the characteristics of eye injuries in the elderly are different from those in the younger population [ 2 , 5 ]. On the other hand, the inconsistency in definition of the elderly population in various reports makes an analysis difficult.…”

Traumas Affecting the Posterior Segment in Geriatric Cases

“…Geriatrik hastalarda eşlik eden birçok sistemik hastalık mevcut olabilmekte ve bu durum da bazen genel anestezi alımını zorlaştırmaktadır. [71] Geniş açılı görüntüleme sistemlerinin kullanıldığı 3 portlu 25 gauge (G) veya 23 G transkonjonktival trokarlı pars plana vitrektomi travma olgularında standart cerrahi prosedürdür. [72] Travmalı bir olguda vitreoretinal cerrahinin belli başlı amaçları mevcuttur.…”