Purpose: The purpose of the present studywas to clarify the reasons for, types of, and degree of involvement
of the orbital wall and the severity of orbital fractures in geriatric patients and to compare the differences
between geriatric and younger adult patients.

Materials and Methods: A retrospective case-control study of geriatric patients aged at least 65 years
(n = 72) and younger controls aged 20 to 50 years (n = 58) with a diagnosis of a unilateral isolated orbital
fracture was designed and implemented. The main exposure was age, the primary outcome was the isolated
orbital fracture type, and the secondary outcomes were the associated orbital zones, fracture area
(cm2), degree of dislocation (mm), involvement of anatomic landmarks, diplopia, altered ocular position,
restricted eyemovement, and ocular injuries. The confounding variables were gender, trauma mechanism,
and alcohol abuse. The statistical methods included c2 tests and logistic regression analyses.

Results: Among the geriatric patients, the great majority of isolated orbital fractures had been caused by
falls (66.7%; P < .001). Geriatric orbital fractures were significantly more often extensive (2 cm2 or larger;
P = .045) and associated with the middle-posterior orbital third (P = .032). In the logistic regression analyses,
the elderly had a 2.2-fold greater risk of fractures of the middle-posterior orbital third and a 2.3-fold
greater risk of extensive fractures compared with the younger controls. Ocular injuries were only diagnosed
in the geriatric patients (5.6%).

Conclusions: Falling is the most common mechanism of elderly orbital fractures. Isolated orbital fractures
are extensive and mainly affect the globe supporting the middle and posterior parts of the orbital
floor among geriatric patients.