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

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    Author
    Fong, YYY; Yu, M; Young, AL; Jhanji, V
    Date
    2015-09-01
    Source Title
    Medicine
    Publisher
    LIPPINCOTT WILLIAMS & WILKINS
    University of Melbourne Author/s
    Jhanji, Vishal
    Affiliation
    Ophthalmology (Eye & Ear Hospital)
    Metadata
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    Document Type
    Journal Article
    Citations
    Fong, Y. Y. Y., Yu, M., Young, A. L. & Jhanji, V. (2015). Presentation and Management Outcomes of Corneal and Scleral Perforations in Geriatric Nursing Home Residents. MEDICINE, 94 (36), https://doi.org/10.1097/MD.0000000000001518.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/257722
    DOI
    10.1097/MD.0000000000001518
    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.

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