Fall-Related Eye Trauma Is on the Rise
By Lynda Seminara
Selected By: Prem S. Subramanian, MD, PhD
British Journal of Ophthalmology
Published online April 23, 2020
To better understand the epidemiology of eye trauma from falls, Usmani et al. reviewed records of patients who presented to U.S. emergency departments (EDs). They found that falls and associated eye injuries are on the rise, with the greatest increase in these eye injuries occurring in the elderly.
The authors gathered data from the Nationwide Emergency Department Sample, which represents a 20% stratified sample of U.S. ED visits. Hospital characteristics were used as stratification criteria, and poststratification weighting was applied to estimate the number of nationwide ED visits. Falls involving eye trauma were identified by diagnostic codes. Multivariate regression was applied to explore relationships between fall-related factors.
During the 10-year study period, there was an increase in the incidence of eye trauma, from 30.7 to 33.8 per 100,000 persons. Although both children and adults ≥ age 45 had a higher incidence of eye trauma with falls relative to adolescents or younger adults, only adults ≥65 years had a disproportionately higher risk of a vision-threatening injury. In addition, substantially more of them required hospital admission. The most common ocular injuries were contusion of the orbital tissues (18.3%), eyelid or periocular laceration (18.1%), and orbital fractures (15.8%). Costs to treat these conditions in the study period, independent of other fall-related injuries, were estimated to exceed $240 million.
The database-driven nature of this study did not allow the authors to identify specific impacts to quality of life as a result of the eye trauma, but severe effects of such injuries have been demonstrated elsewhere. The authors encourage ophthalmologists to collaborate with other specialists to devise strategies to identify and counsel at-risk groups and to reduce eye injury during unavoidable falls. Ophthalmologists should consider early referral of patients to low vision specialists and occupational therapists to reduce risk of falls. Particular emphasis should be given to the elderly, who have the highest risk of debilitating consequences of eye trauma; the authors encourage use of protective eyewear and polycarbonate glasses for these patients.
The original article can be found here.