title: Presentation and Management Outcomes of Corneal and Scleral Perforations in Geriatric Nursing Home Residents.
abstract: We 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.
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital (YYYF, ALY, VJ); Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong (MY, ALY, VJ); Department of Mathematics and Statistics, Hang Seng Management College, Hong Kong (MY); and Centre for Eye Research Australia, University of Melbourne, Victoria, Australia (VJ).
authors.forename: Yoly Yeuk
authors.initials: YY
authors.lastname: Ying Fong
authors.forename: Marco
authors.initials: M
authors.lastname: Yu
authors.forename: Alvin Lerrmann
authors.initials: AL
authors.lastname: Young
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D057112:Corneal Perforation / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D019468:Disease Management; D015817:Eye Infections / Q000150:complications / Q000453:epidemiology; D015807:Eye Injuries, Penetrating / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data*; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D015422:Scleral Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy