Department of Ophthalmology, Ufuk University, Ankara, Turkey.
Department of Ophthalmology, Eberhard Karls University, Tübingen, Baden-Württemberg, Germany.
Graefes Arch Clin Exp Ophthalmol. 2024 Jan;262(1):331-336. doi: 10.1007/s00417-023-06202-1. Epub 2023 Aug 17.
To investigate the clinical characteristics of fall-related ocular trauma in patients over 90 years of age.
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.
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%).
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.
探讨 90 岁以上老年人跌倒相关性眼外伤的临床特征。
回顾性病历回顾分析。在一家三级中心接受治疗的与跌倒相关的眼外伤的 90 岁以上患者被纳入本研究。
分析了 50 例连续患者(50 只眼)。平均年龄为 93.6±1.8 岁,41 例(82%)为女性。最常见的损伤部位是眼眶骨折(18 例,36%),其中 3 例伴有开放性眼球破裂(OGR),2 例伴有眼球挫伤。17 例(34%)患者出现 OGR。这些患者的眼外伤评分在 10 例患者(58.8%)中为 1 类,在其余患者中为 2 类。14 例(28%)患者出现结膜下出血和/或眶周瘀斑,6 例(12%)患者出现眼球挫伤。就诊时,OGR 患者的最佳矫正视力(BCVA)平均为 2.82±0.24 logMAR,6 例眼球挫伤患者的 BCVA 平均为 1.98±0.81 logMAR。3 例 OGR 患者最终视力为 20/200 或更好,而其余患者视力为手动或更差。最常见的危险因素是女性(82%)和使用抗高血压药物(46%)。
尽管早期治疗,OGR 患者的视力预后仍较差。重要的是要提高公众对老年人跌倒相关眼外伤预后不良的认识,以便制定预防措施。