Presentation and Management Outcomes of Corneal and Scleral Perforations in Geriatric Nursing Home Residents

AbstractWe compared the clinical presentation and treatment outcomes of corneal and scleral perforations in geriatric nursing home residents, geriatric community residents, and non-geriatric population. The medical records of patients who were treated for corneal and scleral perforations at the Prince of Wales Hospital, Hong Kong between January 1, 2004 and May 1, 2013, were reviewed retrospectively. Of 144 cases, 53 (37%) occurred in the geriatric population, of which 16 (11%) lived in nursing homes, and 37 (26%) were community residents. There were 91 (63%) patients in the non-geriatric group. The mean age of the patients in nursing home geriatric group was 86.5 years (87.5% females). The most common etiology of perforation was trauma. Rupture due to fall was more common in geriatric patients (P < 0.001) whereas laceration due to penetrating eye injury was more common in non-geriatric patients (P < 0.001). There were more cases of infection leading to spontaneous perforation in geriatric nursing home group compared to the other groups (P = 0.001). In the geriatric nursing home group, visual acuity at presentation (P < 0.001) and postoperative visual acuity (P = 0.012) was worse compared to the other groups. Our study showed that corneal and scleral perforations in the geriatric nursing home residents carry a poor visual prognosis. The causes and anatomical outcomes of such events in geriatric age group differ from those in the general population. In our study, geriatric patients residing in nursing homes had worse baseline as well as posttreatment visual acuity, compared to community residents.

• Publication year

  2015

• Venue

  Medicine

• Publication date

  2015-09-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1097/MD.0000000000001518PMID 26356724PMCID 4616641
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• A 10-YEAR REVIEW OF OPEN-GLOBE TRAUMA IN ELDERLY PATIENTS AT AN URBAN HOSPITAL

  2015influential reference
• Risk factors, microbial profiles and prognosis of microbial keratitis-associated endophthalmitis in high-risk eyes

  2014cited by this paper
• Visual outcome in open globe injuries.

  2012cited by this paper
• Prognostic factors influencing final visual acuity in open globe injuries.

  2011influential reference
• Geriatric traumatic open globe injuries.

  2011influential reference
• Management of corneal perforation.

  2011cited by this paper
• Microbiological and clinical profiles of patients with microbial keratitis residing in nursing homes

  2009cited by this paper
• Will my patient fall?

  2007cited by this paper
• Open globe injuries: factors predictive of poor outcome

  2006cited by this paper
• Who is My Patient?

  2006influential reference
• Prognostic indicators for open globe injury

  2006cited by this paper
• Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries.

  2002influential reference
• Falls in the elderly.

  2000cited by this paper
• Falls in the elderly: what can be done?

  2000cited by this paper
• The global impact of eye injuries.

  1998influential reference
• Falls in the elderly

  1994influential reference

• Disparities in discharge patterns of admitted older patients with ocular trauma.

  2022cites this paper
• Prevalence of Eye Conditions, Utilization of Eye Health Care Services, and Ophthalmic Medications After Entering Residential Aged Care in Australia

  2021cites this paper
• Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015

  2020cites this paper
• Patterns of ocular trauma in elderly patients in an urban population-the Bronx experience

  2020cites this paper
• Major ocular trauma in Taiwan: 2002–2004 versus 2012–2014

  2018cites this paper
• Correlation Between Vision and Cognitive Function in the Elderly

  2016cites this paper