EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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150 | EYEWORLD | APRIL 2019 O UTSIDE THE OR by Vanessa Caceres EyeWorld Contributing Writer Contact information Jarstad: jarstadj@health.missouri.edu Krauss: hkrauss@pacificneuro.org Shah: sms@syeds.org RESEARCH HIGHLIGHT (24.7%), while eye trauma as a secondary diag- nosis was associated with falls (35.2%) and auto crashes (26.6%). Among the falls, 67.3% occurred in older patients. By contrast, in children, unintentional S ome eye trauma hospitalization trends that a recent study tracked may not sur- prise physicians. However, what may be surprising is the increasing role of patient falls for many of these hospitalizations. A study 1 in JAMA Ophthalmolo- gy focused on changes in the incidence of eye trauma hospitalizations in the U.S. between 2001 and 2014. Mustafa Iftikhar, MD, and a team of researchers led by Syed Mahmood Ali Shah, MD, used the National Inpatient Sample (NIS), which they said is the largest publicly available all-pay- er inpatient database in the U.S. The database is sponsored by the U.S. government as part of the Healthcare Cost and Utilization Project and includes as much as 96% of the U.S. population, according to the study. Researchers examined diagnoses and proce- dures for each hospitalization record and used ICD-9-CM codes to identify patients with a pri- mary or secondary diagnosis of eye trauma. Looking at the numbers The study found an estimated 939,608 patients with eye trauma were hospitalized in the U.S. between 2001 and 2014. Of these, 17.1% had a primary diagnosis of eye trauma, while 82.9% had it as a secondary diagnosis. Comparing 2001 to 2014, total eye trauma increased from 18.3 per 100,000 population to 22.0 per 100,000 popu- lation, respectively. "This was because of the increase in eye trauma as a secondary diagnosis, which rose 31% from 14.5 to 19.0 per 100,000 population in the study period," the researchers wrote. At the same time, eye trauma as a primary diagnosis decreased, albeit marginally (from 3.9 to 3.0 per 100,000 population). The most frequent diagnoses for eye trauma as a primary diagnosis included orbital fracture (39.9%), ocular laceration (21.3%), and eyelid laceration (7.7%). When eye trauma was a second- ary diagnosis, the most frequent diagnoses were contusion of the eye and adnexa (37.8%), orbital floor fracture (24.2%), and superficial injury of the eye and adnexa (13.2%). When eye trauma was the primary diagnosis, the main causes were falls (25.3%) and assault Linking eye trauma and falls among the elderly continued on page 152 About the doctors John S. Jarstad, MD Associate professor Director of cataract and refractive surgery University of Missouri School of Medicine Columbia, Missouri Howard R. Krauss, MD Clinical professor of ophthalmology and neurosurgery John Wayne Cancer Institute, Pacific Neuroscience Institute Providence Saint John's Health Center Santa Monica, California Syed Mahmood Ali Shah, MD Associate professor of ophthalmology University of Pittsburgh School of Medicine Pittsburgh 58-year-old male with right partial thickness upper and lower lid lacerations, with microperforation of canalicular system, secondary to assault Source: Jared Weed, MD 10-year-old with pencil thrown in the eye Source: Tarika Thareja, MD