DEMOGRAPHIC, SOCIOECONOMIC AND CLINICAL PROFILE OF OCULAR CHEMICAL INJURIES IN TERTIARY CARE CENTRE IN CENTRAL INDIA

PURPOSE: To identify risk factors of Ocular chemical injuries by studying demographic, socio-economic and clinical characteristics of patients and suggest preventive measures. DESIGN: Prospective hospital-based study. PARTICIPANTS: Patients who presented to tertiary care hospital in central India with ocular chemical burns during February 2019-2020.METHODS:In this study a total of 41 patients (49 eyes) were included.Patient data recorded were Age, Gender, Occupation, Education, socio-economic status, location and mode of injury, type of chemical, use and awareness of Personal Protective Equipment (PPE) and first aid.Clinical characteristics studied were initial and final Best corrected visual acuity (BCVA), grade of injury, Intra- ocular pressure (IOP) at presentation, management and complications.The variables were evaluated for potential relationships with visual outcome.RESULTS:Average age was 32.05+15.1 years with Male:Female ratio of 1.9:1.Total of 13 patients (31.7%) were illiterate,belonged to Upper Lower IV socio-economic class (n=20, 48.8%). Most were semi-skilled workers (n=19, 46.3%) and 61% of the total injuries occurred at workplace.Accidental mode of injury was more prevalent (n=38,92.7%),most common causative chemical was alkali (n=27 eyes,55.1%).Low grade burns (Grade 1,2 and 3) were most observed (n=34,69.38%).Majority of eyes (n=39,79.6%) were medically managed.Risk factors for poor final BCVA using multivariate logistic regression analysis was poor initial BCVA (p =0.011) and grade of chemical injury (p =0.007).Conclusion:Chemical injuries are commonly encountered by patients of low Socio-Economic Status (SES), who are mostly illiterate. Most sustained injury at workplace and were not using PPE.These findings identify need for awareness programs with audio-visual components that are easily understood.It also highlights need for safer workplace practices.

Clinical characteristics of patients hospitalized for ocular chemical injuries in Shanghai from 2012 to 2017

Purpose To summarize the clinical characteristics of patients with ocular chemical injuries and evaluate their potential relationship with the visual outcome by analyzing the medical records of these patients from January 1, 2012, to December 31, 2017. Methods This is a retrospective case series study. Patient data included age, gender, occupational classification, location of ocular chemical injury, initial and final best-corrected distance visual acuity (BCDVA), intraocular pressure (IOP), nature and chemical phase, distribution and severity of chemical injury, management methods, and complications. All variables were evaluated for their potential relationship with visual outcome. Results A total of 160 patients were hospitalized with ocular chemical injuries. Majority of the patients were factory workers and arrived at the consultation room less than 24 h after injury. The most common ocular injury setting, classification of severity, causative chemical, chemical phase, and complications were workplace, grade II, unknown and mixed substance, liquid, and elevated IOP, respectively. The risk factors for poor final BCDVA were identified as older age, poor initial BCDVA, and irrigation 24 h after injury (P < 0.001, P < 0.001, and P = 0.011, respectively). Conclusions We elaborate the clinical characteristics and outcomes of patients with ocular chemical injuries in Jinshan District, Shanghai. A comprehensive education program should be established and the use of protective eyewear should be promoted to prevent occupation-related ocular chemical injuries.

Population-level investigation of the knowledge of ocular chemical injuries and proper immediate action

Objective: Although the eyes occupy 0.1% of the total body surface, eye injuries are serious because vision is arguably the most important sense. We aimed to assess knowledge of Saudi Arabian residents regarding steps to be taken in cases of chemical eye injury, in order to promote awareness of such procedures. Results: This study included 888 individuals in the Saudi community; most of them were female (624, 70.3%), and 359 (40.4%) respondents were 18–29 years of age. Regarding the first step taken in case of chemical eye injury, 697 (78.5%) respondents indicated washing with water, 164 (18.5%) indicated visiting the emergency department, 11 (1.2%) indicated using eye drops, and 5 (0.6%) indicated covering the eye immediately. A total of 491 (55.3%) respondents agreed that alkaline injuries were more dangerous than acidic injuries. Seventy-five (8.4%) respondents agreed that an eye injured with an acidic material should be washed with an alkaline solution, while 60 (6.8%) respondents agreed that an eye exposed to an alkaline material should be washed with an acidic solution. These results should be confirmed by health authorities and appropriate interventions should be developed for improving perception and knowledge among masses, thereby promoting a healthier society.

Management and outcome of a case of severe ocular chemical injury

Ocular chemical injuries may produce extensive damage to surface epithelium,cornea & anterior segment of eye. Most severe injuries have an unfavorable prognosis, but timely & optimal surgical management like Amniotic membrane grafting, Stem cell transplantation, penetrating keratoplasty and in indicated cases, a keratoprosthesis.This case report presents a case of bilateral alkali injury, the management of which was a long drawn & challenging process.