TOPLINE: 

Patients with open globe eye injuries related to falls frequently had new or worsening medical problems or recent changes in medication around the time of the fall and often needed care from non-eye medical specialists. 

METHODOLOGY: 

• Researchers conducted a retrospective review of charts to evaluate the changes in health conditions or medications that occurred around the time of fall-related open globe injuries.
• They reviewed records of adults who experienced open globe injuries related to a fall and were treated at an academic medical center between April 2016 and August 2024. A total of 162 patients were included (mean age, 73.7 years; 59.3% women).
• The primary outcomes were the occurrence of new medical diagnoses, changes in medications, and/or worsening of preexisting systemic conditions. Secondary outcomes included death and new visits to non-eye specialties.
• Researchers assessed the outcomes over a 180-day window, from 90 days before to 90 days after the injury.

TAKEAWAY:

• Over the 180-day window around the injury, 103 patients (63.6%) had at least one new systemic diagnosis that was considered contributory to the fall. The most common diagnoses were infection (n = 32), arrhythmia (n = 21), and chronic musculoskeletal disease (n = 18).
• Preexisting conditions worsened in 26.5% of patients, and 65.1% of these exacerbations were considered contributory to the fall.
• Researchers recorded 351 changes in systemic medications (average, 2.2 per patient), including 67 antimicrobial changes and 16 steroid changes. Antihypertensives were the most common class stopped or decreased.
• Among 141 patients with known vital status, 23 died within 1 year, and the mortality rate was higher in those older than 85 years than in those aged 65 years or younger.

IN PRACTICE:

Open globe injuries secondary to falls “may be sentinel events for underlying systemic disease, worsening pre-existing health status, or medication toxicity,” the researchers reported. “While many of these patients may be categorized as experiencing a mechanical fall, this should not preclude a systemic evaluation for conditions that may have influenced the fall."

"The ophthalmologist should advocate for multidisciplinary evaluation to improve systemic disease detection of high-risk patients and prevent significant morbidity and mortality from future falls and untreated conditions," they added.

SOURCE:

The study was led by Ryan S. Meshkin, MD, of Massachusetts Eye and Ear in Boston. It was published online March 16 in Eye.

LIMITATIONS:

The study was retrospective and had no control group, and therefore could not prove causation. Some falls were purely mechanical, and nearby diagnoses or medication changes may have been unrelated. Not all patients had full medical evaluations, and some follow‑up or diagnoses may have been missing from the records.

DISCLOSURES:

One author reported receiving grants, serving as a consultant, having leadership or fiduciary roles in various organizations, and having stocks or stock options in a commercial eye-related company. The other authors declared having no conflict of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.