Ocular trauma associated with falls in older people: A 10-year review from a state trauma service

Lee, Wen-Shen; McNamara, Philomena; English, James; Meusemann, Robin

doi:10.1016/j.injury.2020.07.029

Cited by 7 publications

(13 citation statements)

References 35 publications

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“…Similar to our study, Lee et al . found that globe trauma can result from low‐impact falls emphasising the need for thorough ocular examination even in seemingly innocuous circumstances 15 . We also found that in younger populations, falls were commonly associated with alcohol and illicit substances.…”

Section: Discussionsupporting

confidence: 51%

“…13,38 Similar to our study, Lee et al found that globe trauma can result from low-impact falls emphasising the need for thorough ocular examination even in seemingly innocuous circumstances. 15 We also found that in younger populations, falls were commonly associated with alcohol and illicit substances. Additionally, there were few patients with alcohol-related falls from Sydney's CBD which may have been influenced by the 'lockout laws' in place at the time.…”

Section: Discussionmentioning

confidence: 53%

“…Lee et al . conducted a 10‐year review of globe trauma associated with falls from standing‐height in the elderly at a trauma centre in Melbourne, Victoria, Australia 15 . Apart from the present study, there has been minimal research into specific fall‐related globe and/or adnexal trauma across all age groups and in other locations in Australia.…”

Section: Introductionmentioning

confidence: 93%

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Globe trauma associated with falls at Australian tertiary centres

Bartimote,

Hoskin,

Fraser

et al. 2023

Emerg Medicine Australasia

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ObjectiveFalls frequently cause globe and adnexal trauma, particularly in the elderly. The morbidity decreases confidence, independence and quality of life. We aimed to improve the understanding of fall‐related globe and adnexal trauma and the involvement of ophthalmology at two tertiary trauma centres.MethodsA retrospective medical record review was conducted at Royal North Shore Hospital and Royal Prince Alfred Hospital of patients admitted with fall‐related globe and/or adnexal trauma between January 2015 and December 2019. International Classification of Disease Tenth Revision codes were used to identify patients for inclusion. Medical records were reviewed to extract data on demographics, trauma, ocular examination and referrals to ophthalmology.ResultsFrom January 2015 to December 2019, 346 patients, 186 were female (54%) and median age 76 years (interquartile range 24 years), were admitted to Royal North Shore Hospital and Royal Prince Alfred Hospital with fall‐related globe and/or adnexal trauma. One hundred and twenty‐five (36%) suffered globe trauma with 48 (14%) classified as severe. Patients over 65 years old had at least three risk factors contributing to falls. Alcohol and illicit substances were involved in 20% of falls and occurred predominantly in younger populations. There were significantly more patients with globe trauma if orbital/mid‐facial fractures were present (55% vs 36%, P < 0.001).ConclusionFall‐related globe and adnexal trauma were more common in the elderly. Alcohol and illicit substances have a role in falls in younger populations. Thorough ocular assessment is required especially in mid‐facial/orbital trauma to exclude globe trauma. Further, research is required to determine the effect of fall prevention strategies in preventing globe trauma.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 93%

See 1 more Smart Citation

Globe trauma associated with falls at Australian tertiary centres

Bartimote,

Hoskin,

Fraser

et al. 2023

Emerg Medicine Australasia

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“…In a previous study reporting the fall-related ocular injuries, the hospitalization rate was reported to be 91% and the need for intensive care was 8.5% [ 11 ]. Only 42% of the patients in the present study were hospitalized, and none of them required intensive care.…”

Section: Discussionmentioning

confidence: 99%

“…In falls over 61 years of age, orbital fracture was seen 21% of the patients and none of the patients had permanent visual or functional impairment due to the fracture [ 12 ]. In another study in patients over 65 years, orbital fractures were with 57% the most common type of injury in fall-related ocular trauma [ 11 ]. Orbital revision was performed in 13% of these patients.…”

Section: Discussionmentioning

confidence: 99%

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

Uzel,

Gosheva,

Neubauer

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose To investigate the clinical characteristics of fall-related ocular trauma in patients over 90 years of age. Methods Retrospective, medical record reviews. Patients over the age of 90 years treated in a tertiary center with fall-related ocular trauma were included in the study. Results Fifty consecutive patients (fifty eyes) were analyzed. The mean age was 93.6 ± 1.8 years and 41 patients (82%) were female. The most common site of the injuries was orbital fracture (18 patients, 36%), accompanied with open globe rupture (OGR) in three patients, and globe contusion in two patients. Seventeen patients (34%) presented with OGR. Ocular trauma score in those patients was category 1 in 10 patients (58.8%) and category 2 in the others. Conjunctival hemorrhage and/or periocular contusion was seen in 14 patients (28%) and globe contusion in six patients (12%). At the presentation, the mean best corrected visual acuity (BCVA) was 2.82 ± 0.24 logMAR in patients with OGR and 1.98 ± 0.81 logMAR in six patients with globe contusion. Three of the patients with OGR had a final vision of 20/200 or better whereas the remaining patients had hand movements or less. The most common risk factors were female gender (82%) and use of antihypertensive drugs (46%). Conclusion Patients with OGR had a poor visual outcome despite the early treatment. It is important to raise public awareness about of the poor prognosis of ocular injuries due to falls in the elderly population in order to establish preventive measures.

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