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Eye trauma in falls presenting to the emergency department from 2006 through 2015
  1. Bushra Usmani1,
  2. Asad Latif2,
  3. Mustafa Iftikhar3,
  4. Yasir J Sepah4,
  5. Channing Parker5,
  6. Justin A Fliss5,
  7. Kunal K Dansingani1,
  8. Syed Mahmood Ali Shah1
  1. 1 Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  2. 2 Armstrong Institute for Patient Safety and Quality, Johns Hopkins University, Baltimore, Maryland, USA
  3. 3 Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
  4. 4 Byers Eye Institute, Stanford University, Stanford, California, USA
  5. 5 Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Syed Mahmood Ali Shah, Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA 15260, USA; sms{at}


Aims To characterise the epidemiology of eye trauma in the event of falls presenting to the emergency departments (ED) in the USA.

Method Retrospective cohort study. Nationwide Emergency Department Sample was used to analyse fall encounters presenting to the ED with eye trauma from 2006 to 2015. National estimates of the leading diagnoses were determined, and multivariable regression was used to determine the relationship between factors involved in fall encounters presenting with eye trauma.

Results From 2006 to 2015, an estimated 87 991 036 fall encounters presented to the ED, of which 952 781 encounters had eye trauma as either a primary or secondary diagnosis. The overall incidence of fall encounters with eye trauma per 100 000 US population increased from 30.7 encounters in 2006 to 33.8 encounters per 100 000 population in 2014 with a decrease seen in 2015. Eye trauma, including vision-threatening type, was highest in females (n=500 520, 52.5%), elderly (n=400 209, 42%) and children (n=2 06 741, 21.7%). Elderly were more likely to have eye trauma in the setting of falls (adjusted OR (aOR) 2.06, 95% CI 2.02 to 2.11) and be admitted (aOR 1.89, 95% CI 1.86 to 1.91) than adults (reference). The leading types of eye trauma were contusion of orbital tissues (n=174 292, 18.3%), laceration of eyelid and periocular area (n=172 361, 18.1%) and orbital fractures (n=151 013, 15.8%).

Conclusions Falls are preventable, yet the incidence of falls and resulting eye trauma are increasing despite our best efforts. As ophthalmologists, we should not only develop guidelines to recognise and counsel at-risk groups under our care but also strategies for prevention of eye trauma secondary to falls.

  • epidemiology
  • epidemiology
  • trauma

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The University of Pittsburgh Institutional Review Board approved the study and since the database does not contain any direct patient identifiers, informed consent was not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available. This data set was purchased through HCUP.

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