Abstract
Purpose :
To determine the epidemiology of eye trauma in the event of falls presenting to the Emergency Departments (ED) in the United States (US).
Methods :
Nationwide Emergency Department Sample was used to create a US national estimate of patients presenting with eye trauma as primary or secondary diagnosis in the event of a fall to ED from 2009 to 2014. Incidence was calculated using US National Census Data. Multivariate regression was used to estimate the changes in incidence and to compare the demographics between patients with and without eye trauma.
Results :
From 2009 to 2014, an estimated 55,511,782 patients presented with unintentional falls, of which 604,581 patients had eye trauma as either a primary (n=278,055, 46%) or secondary (n=326,526, 54%) ophthalmic diagnosis. The incidence of eye trauma increased from 31.5 per 100,000 population in 2009 to 33.8 per 100,000 population in 2014. Eye trauma was highest in patients > 65 years (elderly) followed by patients between 20-44 years (adults), 45-64 years (middle-aged), 1-12 years (children), 13-19 years (adolescents) and 0-1 year (infants). Incidence of eye trauma increased from 2009 to 2014 in elderly (102.4 to 107.2 per 100,000 population), middle aged (21.8 to 25.4 per 100,000 population), and adults (12.9 to 13.9 per 100,000 population). Orbital fracture was the most frequent traumatic diagnosis in middle aged and elderly, while periocular laceration was the most frequent diagnosis in all other age groups. Eye trauma was more common in females, (n=320,461, 53%). A larger proportion of patients belonged to the lower two income quartiles (first quartile n=152895 [26%], second quartile n= 152632 [26%]). Overall, most patients had public insurance (Medicare or Medicaid, n=364,973 61%), followed by private insurance (n= 158948, 26%). Ophthalmic diagnosis was more likely to be traumatic in elderly patients with falls (adjusted Odds Ratio [aOR], 2.43,[95% CI, 2.36-2.50]) followed by children (aOR,[1.88, 95% CI, 1.84-1.93]).
Conclusions :
Incidence of eye trauma in the setting of falls is increasing, especially in the elderly and children, and can result in visual loss in these vulnerable age-groups. As ophthalmologists, we should recognize at-risk groups and devise additional strategies for prevention of eye trauma secondary to unintentional falls.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.