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Fall-related open globe injuries are associated with systemic health changes

Eye (2026)Cite this article

Subjects

Abstract

Purpose

To characterise peri-injury systemic health changes in patients with fall-related open globe injuries (OGIs).

Design

Retrospective cohort study.

Participants

162 patients with fall-related OGIs, identified from a cohort of 1016 consecutive OGIs treated at a single academic medical center between 2016 and 2024.

Methods

Electronic medical records were reviewed. Patients were included if the injury resulted from a fall and sufficient systemic health data were available.

Main outcome measures

Incidence of new systemic diagnoses, disease exacerbations, and medication changes occurring within 90 days before or after the OGI. Specialist visits within the window and one-year mortality data were secondary measures.

Results

Of 1016 OGIs, 223 were fall-related (59.3% female, mean age 73.7 ± 14.3). Of 162 patients meeting inclusion criteria, 103 (63.6%) had at least one new systemic diagnosis likely contributing to the fall. Forty-three patients (26.5%) experienced exacerbation of pre-existing conditions, 28 (65.1%) of which were considered contributory to the fall. A total of 351 medication changes were documented, including medication classes with known fall risk. Seventy patients (43.2%) were seen by a new specialist; 38 of 108 visits (35.2%) were trauma-related, while 70 (64.8%) addressed new non-ocular conditions. Age-stratified one-year mortality rates were: ≤65 years, 9.7%; 66–75, 15.0%; 76–85, 16.7%; >85, 45.0%.

Conclusions

Most fall-related OGIs occur in the context of newly diagnosed systemic illness, worsening of chronic disease, or medication changes. These injuries may represent sentinel events signaling underlying health deterioration. Systemic evaluation at initial presentation could facilitate timely referral and management of serious non-ophthalmic conditions.

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Fig. 1: Boxplot graph of contributory diagnoses to OGI.
Fig. 2: Mean medication changes by class.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Author information

Author notes

  1. These authors contributed equally: Ryan S. Meshkin, Eric T. Strand.

Authors and Affiliations

  1. Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA

    Ryan S. Meshkin, Grayson W. Armstrong, Matthew F. Gardiner & Isaac D. Bleicher

  2. Department of Ophthalmology, Harvard Medical School, Boston, MA, USA

    Ryan S. Meshkin, Grayson W. Armstrong, Matthew F. Gardiner & Isaac D. Bleicher

  3. Harvard Medical School, Boston, MA, USA

    Eric T. Strand

Authors
  1. Ryan S. Meshkin
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  2. Eric T. Strand
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  5. Isaac D. Bleicher
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Contributions

RWM: methodology, investigation, data curation, formal analysis, and writing, ETS: investigation, data curation, formal analysis, visualisation, and writing, GWA: data curation, validation, writing, MFG: data curation, validation, writing, IDB: conceptualisation, methodology, investigation, data curation, validation, supervision, and writing. RSM was responsible for study design, data collection, data analysis, medical review, and manuscript preparation and editing. ETS was responsible for study design, data collection, data analysis, and manuscript preparation and editing. IB was responsible for study design, data analysis, medical review, and manuscript preparation and editing. GWA and MG provided feedback on the manuscript.

Corresponding author

Correspondence to Isaac D. Bleicher.

Ethics declarations

Competing interests

G.W.A.: Grants – AMD Foundation, Centers for Disease Control and Prevention, DKBMed; Consultant – Kriya Therapeutics, Xenon Ophthalmics, Chart Biopsy, McKinsey & Company, Ocular Technologies, Dynamed, Genentech; Leadership or fiduciary role – Massachusetts Society of Eye Physicians and Surgeons, Digital Ophthalmic Society, Middlesex District Medical Society, Massachusetts Medical Society, American Society of Ophthalmic Trauma; Stock or stock options – Ocular Technologies. The other authors have no relevant financial disclosures. The authors declare that they have no conflict of interest.

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Meeting Presentation: American Academy of Ophthalmology, 2025.

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Meshkin, R.S., Strand, E.T., Armstrong, G.W. et al. Fall-related open globe injuries are associated with systemic health changes. Eye (2026). https://doi.org/10.1038/s41433-026-04401-8

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