To review the pattern of open globe injuries among geriatrics and prognostic factors associated with postoperative visual acuity.

Data from 226 known cases of open globe injuries aged 60 years and more that have been presented to Farabi Eye Hospital during 4 years, were reviewed.

Main outcomes measures were demographic and clinical data including age, gender, type of open globe injury, mechanism of injury, Ocular Trauma Score (OTS), initial visual acuity, comorbidities, associated injuries, zone of injury, time lapse, previous intra ocular surgeries, postoperative visual acuity. Results: From 226 patients 227 eyes were injured. Mean age was 70.7 ± 8.3 years. Men outnumbered Women by 3.2 to 1. Penetrating injury was more frequent than other types of open globe injuries. The three most common mechanisms of injuries were falling (17.7%), tree branch (15.9%) and projectiles (13.3%). Raw OTS median was 60 and the most common ocular trauma class was class 3. Zone I was the most frequent zone of injuries in geriatrics. RAPD was detected in 19/9% of cases. 31.4% of patients had a history of previous intra ocular surgeries especially cataract surgery. The median preoperative visual acuity was light perception in the geriatric patients and the median postoperative visual acuity was hand motion. There were 3 cases of endophthalmitis and 9 patients underwent enucleation. Calculated OTS was negatively associated with postoperative visual acuity (p-value 0.004). No association was found between initial visual acuity, time lapse, zone of injury and presence of RAPD with postoperative visual acuity.

The most frequent leading cause in geriatric open globe injuries is falling. Prognosis of open globe injuries seems to be guarded according to the visual outcomes. OTS remains the most important prognostic factor.