Globe trauma associated with falls at Australian tertiary centres

Area of Science:

• Ophthalmology
• Trauma Surgery
• Geriatrics

Background:

• Falls are a significant cause of globe and adnexal trauma, particularly impacting the elderly population.
• This trauma can lead to decreased confidence, independence, and overall quality of life.

Purpose of the Study:

• To enhance the understanding of globe and adnexal trauma resulting from falls.
• To investigate the role of ophthalmology in managing these injuries at two major trauma centers.

Main Methods:

• A retrospective review of medical records was conducted for 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 for patient identification, with data extracted on demographics, trauma specifics, ocular examination findings, and ophthalmology referrals.

Main Results:

• Out of 346 patients, 125 (36%) sustained globe trauma, with 48 (14%) classified as severe. The median age was 76 years.
• Elderly patients (over 65) often had multiple risk factors for falls. Alcohol and illicit substance use were implicated in 20% of falls, predominantly in younger individuals.
• Globe trauma was significantly more prevalent in patients with co-existing orbital/mid-facial fractures (55% vs. 36%, P < 0.001).

Conclusions:

• Fall-related globe and adnexal trauma disproportionately affect the elderly, while substance use is a factor in younger populations.
• A thorough ocular assessment is crucial for all patients with mid-facial or orbital trauma to rule out globe injury.
• Further research is needed to evaluate the effectiveness of fall prevention strategies in mitigating globe trauma.