September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Aetiology and injury patterns of orbital fractures across age groups in a tertiary centre in Singapore: A retrospective study of 333 patients.
Author Affiliations & Notes
  • Kailing Yong
    Singapore National Eye Centre, Singapore, Singapore
    Singapore Eye Research Institute, Singapore, Singapore
  • ian loh
    ENT, Changi General Hospital, Singapore, Singapore
  • sunny shen
    Singapore National Eye Centre, Singapore, Singapore
    Singapore Eye Research Institute, Singapore, Singapore
  • Footnotes
    Commercial Relationships   Kailing Yong, None; ian loh, None; sunny shen, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3048. doi:
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      Kailing Yong, ian loh, sunny shen; Aetiology and injury patterns of orbital fractures across age groups in a tertiary centre in Singapore: A retrospective study of 333 patients.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3048.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The purpose of the present study was to investigate the trauma mechanisms and resulting orbital fractures in elderly patients and to compare them with those of younger adults.

Methods : This retrospective study evaluated 333 subjects who sustained orbital fractures between 2011 to 2015 in a tertiary centre in Singapore. All patients had radiological confirmation of orbital fractures on computed tomography scans. The subjects were divided into young (≤40 years, n=126), middle-aged (41 to 65 years, n=106) and elderly (>65 years, n=101).

Results : The mean age (standard deviation, SD) of the study population was 51.0 (21.0) years, and 242 (72.7%) were male. The mean number of orbital wall fractured was 1.71 (0.72), and the most common wall fractured was the floor (75.1%), followed by lateral wall (44.4%), medial wall (37.8%) and roof (14.1%). Forty-four percent of the injuries were associated with a zygomatico-maxillary complex (ZMC) fracture, and 13.8% of subjects had a concomitant intracranial haemorrhage. About one-third of patients (36.4%) had surgical intervention. The mechanisms of injury were significantly different across the 3 age group (p<0.001); The most common cause of fracture in the elderly was falls (80.2%), while in the young age group the most common causes were road traffic accident (31.7%) and assault (31.0%). For the middle-aged group, falls accounted for 40.5% of the injuries, road traffic accident 27.4% and assault 22.6% (Figure 1). There were no significant differences between the age groups and number of orbital walls fractured (p=0.97), associated ZMC fractures (p=0.15) and intracranial haemorrhage (p=0.51). Three patients had globe rupture and 4 patients had significant retrobulbar haemorrhage requiring immediate cantholysis.

Conclusions : Age-related factors predispose the elderly to falls and subsequent orbital fractures. A significant proportion of patients with orbital fractures were associated with intracranial haemorrhage and morbidity, hence orbital fractures should be strongly suspected in the elderly and a lower threshold for performing a scan.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Figure 1: Mechanisms of injury across different age groups

Figure 1: Mechanisms of injury across different age groups

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