Title: Visual Outcome and Complications in Patients with Ocular Chemical Injuries

Authors: Dr Nimmy Merin Mathew, Dr Mallika. O.U

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i3.166

Abstract

Purpose: To  assess the visual outcome and the severity of injury and complications in patients with ocular chemical injury

Materials and Methods: In a tertiary hospital based prospective single cohort study all patients who presented with ocular chemical injuries to Ophthalmology outpatient department during a period of one and a half years were studied. Data regarding the history of injury with special emphasis to type of chemical, site and mode of exposure and time between injury and presentation to the hospital was taken. Visual acuity at the time of presentation was assessed and the severity of injury was studied by slit lamp examination. The patient was followed up on day1, day 3, at 2 weeks and at 2 months to assess the visual outcome and complications after the injury.

Results: among the 34 eyes with chemical injury, 52.9% were alkali injuries,32.4%  were acid injuries and rest due to other chemicals. According to Roper Hall grading, grade 1 injury was present in 44.1% cases, grade 2 injury in 29.4 % cases, grade 3 injury in 20.6% cases and grade 4 or severe injury was seen in only 2 eyes (5.9%) cases. on review after 2 months, 30 eyes had best corrected visual acuity improved to 6/6 - 6/18 (88.2%). Still, 3 eyes (8.8%) had their visual acuity in the range of 6/24 - 3/60 and one eye had visual acuity <3/60.

Conclusion: Alkali injuries were more and the incidence was more in the younger working population, with majority of injuries occurred in less than 40 years of age. The severity of injuries were less with most of them belonging to grade 1 and grade 2 injuries. Henceforth the visual outcome was better and complications were much less at 2 months follow up.

References

1.      Singh P, Tyagi M, Kumar Y, Gupta KK, Sharma PD. Ocular chemical injuries and their management. Oman J Ophthalmol. 2013;6(2):83-86.

2.      Maskati BT, Adrianwala SD. Chemical burns of the conjunctiva and cornea. 1968;16(4):228-231

3.      Hong J, Qiu T, Wei A, Sun X, Xu J. Clinical characteristics and visual outcome of severe ocular chemical injuries in Shanghai. Ophthalmology. 2010 Dec; 117(12):2268-72.

4.      Kuckelkorn R, Kottek A, Schrage N, Reim M. Poor prognosis of severe chemical and thermal eye burns: the need for adequate emergency care and primary prevention. Int Arch Occup Environ Health. 1995;67(4):281-4.

5.      Gomaa A, Comyn O, Liu C. Keratoprostheses in clinical practice - a review. Clin Experiment Ophthalmol. 2010 Mar;38(2):211-24.

6.      Hunt JP, Calvert CT, Peck MD, Meyer AA. Occupation-related burn injuries. J Burn Care Rehabil. 2000 Jul-Aug;21(4):327-32.

7.      Das S, Kabir MF, Das J, Hannan AA, Chowdhury MW, Anwar SMN et al. Pattern of Chemical Ocular Injury: A Clinical Study. Chattagram Maa-O-Shishu Hospital Medical College Journal. 2014 Jan;13(1):42-45.

8.      Vajpayee RB, Shekhar H, Sharma N, Jhanji V. Demographic and clinical profile of ocular chemical injuries in the pediatric age group. Ophthalmology. 2014 Jan;121 (1):377-80.

9.      Dua HS, King AJ, Joseph A. A new classification of ocular surface burns. Br J Ophthalmol. 2001 Nov;85(11):1379-83

10.  Roper-Hall MJ. Thermal and chemical burns. Trans Ophthalmol Soc U K. 1965;85:631-53.

Corresponding Author

Dr Nimmy Merin Mathew

Puliyampallil House, Manjoor P.O, Kuruppanthara, Kottayam Dist, Kerala. PIN-686603

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