Falls in older patients linked to sight-threatening ocular injuries

Ocular injuries resulting from falls in patients over 65 years of age is associated with significant rates of in-hospital mortality and poor functional outcomes, according to a study.

In addition, the incidence of permanent blindness was 10.4% in the study.

In this retrospective study, 270 patients over 65 years referred to the Ophthalmology Department of a tertiary hospital following fall from standing height were included, including 155 for orbital fractures, 23 for severe ocular injuries included globe rupture, 22 for retro-bulbar haematoma, 6 for retinal detachment, and 6 for traumatic optic neuropathy.

Approximately, 15% of patients had a visual acuity (VA) below 6/60. Visual acuity was not measured due to delirium or intubation in 34 patients (12.5%), 9 of which had a significant ocular injury.

In total, 10.4% of patients were permanently blinded as a result of their injuries, 8.5% required admission to the ICU, and 5.93% died during their hospital stay. All injuries, except a globe rupture, that required emergency surgery were operated on within 24 hours.

The authors concluded that “it is essential for trauma practitioners to perform a detailed and systematic assessment in order to identify sight-threatening ocular injuries and allow for expedient sight-saving intervention to be performed.”

Reference

Lee WS, McNamara P, English J, et al. Ocular trauma associated with falls in older people: A 10-year review from a state trauma service. Injury. 2020; DOI:https://doi.org/10.1016/j.injury.2020.07.029