Chemical injury to eye- A case report

Chemical burns represent blinding ocular injuries and constitute an ocular emergency requiring immediate assessment and initiation of treatment. The majority of patients are of young age groups and exposure will occur anywhere as an accident and in association with criminal assaults too. Alkali injuries occur more frequently. Chemical injuries of the eye produce extensive damage to the conjunctiva, cornea, anterior segment and limbal stem cells resulting in unilateral or bilateral visual impairment. This article reviews the emergency management to improve the prognosis of patients with chemical injuries

Factors Causing Ocular Injuries among Workers in Construction Industry in Malaysia

@#Introduction: Safety establishments at the workplace play a vital part in preventing ocular injuries in construction industries. Ocular injuries worsens the quality of life of workers, leading to economic loss. The arising of ocular injuries at emergency departments trigger a public health concern in Malaysia. This study aimed to investigate the factors causing ocular injuries among construction workers in Selangor, Malaysia. Methods: A cross-sectional study was conducted on construction workers in Klang Valley, Malaysia. A validated questionnaire evaluated factors consisting of environmental, behaviour and practice domains (α= 0.70 – 0.90) and Reichert Portable Slit Lamp assessed ocular injuries. Results: A total of 385 workers aged 18 to 65 years old completed the study. The prevalence of ocular injuries was 66.20% (n=255 eyes) which includes foreign body injuries (28.20%), subconjunctival haemorrhage (9.20%), corneal haze (4.75%), laceration (1.78%), corneal burn (1.18%) and traumatic cataract (0.29%). Environmental hazards such as dust 70.40% (n=271, p=0.00), chemical 75.80% ( n= 292, p=0.00), heat 68.10% (n=262, p=0.00), equipment 60.5% (n=233, p=0.00), fall 54.80% (n=211, p=0.00) and limited working space 52.70% (n=203, p=0.00) significantly contributed to the ocular injuries. However, behaviour and awareness did not contribute significantly to ocular injuries (p<0.05). Conclusion: This study shows high prevalence of ocular injuries among construction workers in Klang Valley. The main factors causing ocular injuries are environmental factors. Thus, safety assessments including usage of PPE, training and closed monitoring are required to improve the eye safety and health at the construction sites.

Impact on the pattern of ocular injuries and awareness following a ban on firecrackers in New Delhi: A tertiary eye hospital-based study

Purpose: To review the nature of firecracker-related ocular injuries at a tertiary eye hospital in northern India following the firecracker ban and also to review the level of awareness among the victims. Methods: A cross-sectional observational study involving the patients presenting with firecracker-related ocular injuries from October 18 to 27, 2017 were assessed for demographic distribution, detailed ocular evaluation, and a questionnaire related to the awareness about the injuries. Results: A total of 68 patients were observed. Fifty patients (74.5%) were males. This year, a majority of patients were from outside Delhi. Uttar Pradesh constituted the most 38.23% of the patients followed by Haryana 30.88%, Delhi 23.5%, and Bihar 7.35%. Visual acuity varied from 6/6 to no perception of light. Open globe injury was observed in 56 patients (82.35%) who commonly had zone I injury. A significant number of patients (88.23%) were aware of firecracker-related injuries, and a large number of such injuries (58.8%) occurred in those who were not actively involved in the ignition of firecrackers but were in the vicinity. Conclusion: This year, following a ban, the number of firecracker-related ocular injuries reported from areas outside Delhi outnumbered as compared to within Delhi. However, firecracker-related ocular injuries are still a major cause of significant visual loss, especially involving the bystanders. Thus, firecracker-related celebrations should be monitored with a stringent protocol.

Pattern of ocular injuries at tertiary care hospital, Valsad

Background: Ocular injury is the most common cause for visual morbidity and blindness and should not be neglected at all. Materials and methods: A retrospective study was conducted at GMERS Medical College, Valsad on patients who came to Ophthalmology Department from January 2015 to December 2016 for period of 2 years. Outdoor as well as indoor patients were included in the study with history of ocular injury. Data were collected from clinical records and analyzed to study pattern of ocular injuries. Results: Total 100 cases were studied, out of which 74 were male and 26 were female with history of ocular injury. Maximum numbers of patients were in age group of 21 to 30 years. Road traffic accidents were the most common cause of ocular trauma among all patients. Conjunctival hemorrhage and scleral hemorrhage were more common among all. Conclusion: This study showed that road traffic accidents were the commonest causes of ocular injuries and conjunctival hemorrhage was the most common type of ocular injury.

Profile of ocular injury in pediatric age group / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the clinical profile of ocular injuries in children in a tertiary care center in Northern India.<p>METHODS: This was a hospital based descriptive study. All children of ocular injuries up to 16y of age were included. Data regarding the socio-economic status, medical/surgical treatment, and condition at discharge were recorded. Follow-up to 3mo was done in the study. Initial and final visual acuity was recorded. Ocular Trauma Classification Group guidelines and Birmingham Eye Trauma Terminology were used for the definitions and classifications of ocular trauma. Socio-economic status grading is done according to modified B.G. Prasad classification and Kuppuswamy's socio-economic scale.<p>RESULTS: Out of 42 children, male to female ratio was 3.6:1.Maximum number(50%)of injuries occurred between 11-16y of age. Most of the children(59.52%)belonged to lower socio-economic class and were from arural background. Ocular injuries occurred at home in 20(47.61%)children followed by 6(14.28%)each in school, playground, and street. Open globe injuries were seen in 19(45.24%)children and 23(54.75%)children had closed globe injuries. Injuries by wooden stick, stone, firework, fall, toy were 12(28.57%), 5(11.90%), 3(7.14%), 3(7.14%), and 2(4.76%). Seventeen(40.47%)children required medical management and 25(59.53%)were treated surgically.<p>CONCLUSION:Male children in rural regions and of lower socio-economic background were more prone to ocular injuries. Children were more risk of ocular injuries at home. Wooden sticks and stone were the commonest cause of ocular injuries. Ocular morbidity and poor visual outcome were seen more in open globe injuries. Further population-based studies are required to reinforce findings of present study. Based on this, a long term strategy can be planned to prevent ocular injuries in children in this region.

Spectrum of ocular firework injuries in children: A 5‑year retrospective study during a festive season in Southern India.

Purpose: Ocular trauma is a major cause of acquired monocular blindness in children. Firework injuries account for 20% of ocular trauma. The purpose of our study was to document the profile of ocular firework injuries in children during the festive season of Diwali and to determine the prevalence of unilateral blindness in them. Materials and Methods: A retrospective chart analysis of ocular firework injury in children during the festival of Diwali from 2009 to 2013, conducted in a tertiary care eye center in Tamil Nadu, Southern India. Children below 18 years of age with ocular firework injuries who presented to the emergency department for 3 consecutive days ‑ the day of Diwali, 1 day before, and 1 day after Diwali ‑ were included in this study. Results: Eighty‑four children presented with firework‑related ocular injuries during the study period. Male to female ratio was 4:1 with mean age 9.48 ± 4 years. Forty‑four percentage required hospitalization. The prevalence of unilateral blindness in children due to fireworks was found to be 8% (95% confidence interval ‑ 2–13%). Conclusion: Vision 2020 gives high priority to avoidable blindness, especially in children. In our study, for every 12 children who presented with firecracker injury, one resulted in unilateral blindness. This is an avoidable cause of blindness. Awareness needs to be created, and changes in policy regarding sales and handling of firecrackers including mandatory use of protective eyewear should be considered.

Ocular trauma from land mines among soldiers treated at a University Hospital in Medellin, Colombia / Caracterización del trauma ocular por minas antipersonales en soldados atendidos en un hospital Universitario en Medellín, Colombia

Introduction: Currently ocular combat injuries are complex and associated with poor visual outcomes. Our objective is to characterize the military population that suffer land mine combat ocular trauma in Colombia and identify the type of wound, treatment and visual outcomes. Methods: Retrospectively review of medical history of soldiers evaluated in Pablo Tobon Uribe Hospital, whom had land mine trauma during January of 2004 and December 2012. Results: 635 soldiers had land mine trauma, 153 of them had ocular trauma (226 eyes). Open ocular trauma was observed in 29.6%. The Ocular Trauma Score was calculated in 183 eyes, the initial visual acuity was not possible to be reported in the rest of them; the 45% of the eyes were classified in category 3. Three patients had no light perception in both eyes. 97.3% of the eyes received medical treatment and 49.1% had surgery also. Primary evisceration was made in 5.8% and enucleation in 1.8%. Intraocular foreign body was observed by ultrasonography in 11.1% and in 5.8% by orbital tomography. Eleven patients were legally blind at discharge. Conclusions: The ocular trauma related to a land mine is highly destructive at an ocular level. The treatments associated with better visual outcomes are primary closure of globe and systemic antibiotics; although the characteristics of the wound itself are the main prognostic factor. The Ocular trauma score is a useful tool for determining visual outcome in combat ocular trauma.

Introducción: Los combates armados generan heridas oculares complejas con mal pronóstico visual. Nuestro objetivo es caracterizar la población militar que sufre trauma ocular de combate en Colombia asociado a minas antipersona, así como las características de las lesiones, el tratamiento recibido y desenlace visual final. Métodos: Se evaluó retrospectivamente las historias clínicas de soldados atendidos en el Hospital Pablo Tobon Uribe, que sufrieron accidente por mina antipersona durante el período entre enero de 2004 y diciembre de 2012. Resultados: 635 soldados, sufrieron trauma por mina antipersona; de estos, 153 (226 ojos) tuvieron trauma ocular. El 29.6% tuvieron trauma abierto. Se calculó el Ocular Trauma Score en 183 ojos. El 45% de los ojos se clasificaron como categoría 3. Tres pacientes tuvieron una visión final de no percepción de luz por ambos ojos. El 97.3% de los ojos tuvieron tratamiento farmacológico y 49.1% recibieron cirugía además. Se realizó evisceración primaria en el 5.8% y enucleación en 1.8%. Se logró comprobar cuerpo extraño intraocular por ecografía en el 11.1% y por tomografía de órbitas en el 5.8%. Once pacientes fueron legalmente ciegos, al momento de abandonar el hospital. Conclusiones: Las principales medidas terapéuticas asociadas con mejoría del pronóstico visual son el cierre primario de herida y la administración de antibióticos; aunque las características de las heridas oculares son el principal factor pronóstico. El Ocular Trauma Score es una herramienta útil para determinar el pronóstico visual en trauma ocular de combate.

Visual profile of motorcycle-related ocular trauma in a tertiary hospital

Objectives@#To provide a representative data on the local profile of motorcycle-related ocular trauma seen in a tertiary hospital over a period of one year.@*Methodology@#A retrospective case review of all motorcycle-related trauma patients seen at the emergency room of the Philippine General Hospital (PGH) by the Trauma Service of the Department of Surgery and referred to the Department of Ophthalmology and Visual Sciences (DOVS) for eye injuries was conducted. Descriptive statistics were used to determine the prevalence and types of injuries, and the factors affecting these injuries. @*Results@#Thrity-four charts were reviewed; 9 (26.5%) patients had bilateral ocular involvement and 25 (73.5%) unilateral, a total of 43 eyes. The patients were mostly males in their productive age, belonged to the lower economic bracket, and came from nearby Southern Luzon provinces and the National Capital Region (NCR). Most of the injuries incurred were mild and involved the external surface of the eye. Night motorcycle driving, fair weather, and alcohol use were risks identified for motorcycle-related ocular injuries. Helmet use was the only identifiable risk indirectly correlated with severity of ocular injury. @*Conclusion@#Although majority of the ophthalmic injuries were classified as mild, and eyes involved had generally good visual potential, helmet use was the only identifiable risk associated with the severity of the ocular injury

Open globe injuries in the child population in hyderabad / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To evaluate the causes, frequency, severity of eye injury, management, visual outcome and prevention in children with penetrating ocular injury.·METHODS: The study was conducted on patients under 15 years presenting with penetrating ocular injuries. Anterior segment slit lamp examination was performed for cornea and corneo-scleral penetration, hyphema, iris prolapse, etc. Posterior segment slit lamp examination wih 90D funduscopes was done in selected cases. After performing necessary investigations, urgent surgical intervention was carried out. ·RESULTS: Out of 43 (55%) registered patients; boys were 67%, and girls 33%. The agents of trauma were glass, pencil, stick, etc. The site of entrance through cornea was 62.7%, sclera 25.6%, and limbus 11.7%. The presenting visual acuity was 6/60 and above in 32.5% children, 6/24 in 9.3%, and 6/12 and above in 2.3% cases. 37.2% cases had perception of light. Out of 36 operated eyes, twenty-nine completed post operative follow up. 10 4% subjects had final visual acuity (FVA) of 3/60. 24 2% had FVA of 6/60. 17.2% children had FVA of 6/24 partial. In 34.4% subjects, the FVA was restricted to perception of light. 10.4% developed phthisis bulbi.·CONCLUSION: Ocular trauma is a significant cause of visual loss in child population. Preventive efforts are extremely important in domestic and outdoor activities.

Clinical analysis of 124 patients with penetrating ocular injuries in Hyderabad Pakistan / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To assess the common causes of penetrating ocular injuries and to determine the visual outcome of these cases.·METHODS:A total of one hundred and twenty four eyes of 124 patients suffering from penetrating ocular injury between the ages 6-60 years, presenting to the Department of Ophthalmology,Liaquat University of Medical and Health Sciences were assessed clinically to determine the common causes of the penetrating intraocular injury and the final visual outcome.·RESULTS:One hundred and twenty four eyes with penetrating ocular injuries were enrolled in the study.The mean age was 35 years,(range 6 to 60 years).Males were predominant 86.3% with most of the patients less than 20 years of age (71%).Occupational class was mostly affected by the intraocular injuries accounting to 76%.51% patients had best corrected final visual acuity between perception of light to 6/60.Among the 124 patients in whom both initial and final visual acuities were reliably recorded,there was a correlation between poor initial visual acuity and poor final visual acuity.·CONCLUSION:Penetrating eye injury is a common incident, predominantly in young males and often resulting in poor visual outcome in the injured eye.Labour work without protective measures and children playing with hazardous objects are associated with more frequent and severe ocular injuries.

Clinical Evaluation of the Associated Ocular Injuries of Orbital wall fracture Patients

PURPOSE: To describe the demographics, etiologic factors, clinical presentations, and associated ocular injuries in orbital wall fracture patients. MATERIALS AND METHODS: We retrospectively analysed 172 eyes of 144 patients with orbital wall fractures who visited emergency room & department of ophthalmology from 2000 to 2001. Clinical features such as age, sex, causes of injury, sites of orbital wall fractures, associated ocular injuries, number of associated injuries according to the site of orbital wall fractures, site of orbital wall fractures according to the associated injuries, associated injuries according to the number of orbital wall fractures. RESULTS:Total number of patients was 144 (172 eyes), 108 patients (75.0%) were men and 36 patients (25.0%) were women. Mostly, they were under 50 years of age. Traffic accidents (44.4%) was the most common cause of injury and medial wall (37.8%) was most common site of orbital wall fractures. Commotio retina (36.8%), Hyphema (8.8%), Eyelid laceration (19.3%), Traumatic optic neuropathy (5.7%) were most commonly associated injuries. The more number of wall fracture, the more occurred associated injuries. When more stronger force, such as lateral wall fracture, was accompanied, the associated injuries were more common. CONCLUSIONS: High prevalence of ocular and extraocular injury with orbital wall fractures emphasizes the need for a comprehensive ophthalmic evaluation and long-term follow-up.

Traumatic cataract optical dysopia and its forensic identification / 中国法医学杂志

The identification traumatic cataract must be based on the optical dysopia after ocular injuries. 72 cases of traumatic cataract were classified into 3 groups according to the classification of WHO about optical dysopia. There were 9 cases low vision, 58 cases blind and 5 incorporated cases after injuries. After operation, there were 12 cases that stenopeic spectacles vision was 0.4～1.2, 29 cases were low vision, 26 cases blind. The results suggested that the vision of traumatic cataract could be changed after operation, and the best time for forensic identification could be 1 or 2 months after operation.

Ocular war injuries

1. 14 cases of uniocular injuries due to bomb explosion are reviewed2. The majority of the lesions consisted of perforating wounds of the globe constituting a percentage of 78.57%3. In ocular war injuries one observation was the amount of damage seen or the extent of injury was much greater than was revealed by the external appearance of the wound4. Sympathetic ophthalmia was not observed in our cases due to early preventive enucleation which is the best prophylaxis against the occurence of sympathetic ophthalmia. (Summary and conclusion)

Surgical Result of Vitrectomy in Ocular Trauma

We reviewed 49 patients(50 eyes) who had undergone pars plana vitrectomy for the traumatized eyes during the last 4 years. We divided patients into 4 groups according to the characteristics of ocular injuries-anterior segment Injury, posterior penetrating injury, intraocular foreign body and blunt injury. We analyzed surgical results and compared surgical outcomes according to timing of vitrectomy performed(within 2 weeks VS more than 2 weeks after trauma). Anatomical success was achieved in 36 eyes(72.0%) and functional success was achieved in 23 eyes(46.0%). The main causes of functional and anatomical failure were macular pucker and phthisis bulbi respectively. The anatomical and functional success rates were higher when vitrectomy was performed within 2 weeks after trauma. In posterior penetrating injury group, however, anatomical success rate was lower when vitrectomy was performed more than 2 weeks after trauma. The frequency of retinal detachment was higher when vitrectomy was performed more than 2 weeks after trauma. In cases of intraocular foreign body, retinal detachments were developed in all patients after vitrectomy performed more than 2 weeks after trauma. If vitrectomy is required for patients with ocular injury, we suggest vitrectomy within 2 weeks after frauma for better chance to perserve the globe and for salvaging vision.

A Statistical Observation of the Ocular Injuries

The 1,783 patients with eye injuries, including the 234 in-patients, who visited the Department of Ophthalmology, Seoul Adventist Hospital from Jan. 1, 1987 to Dec. 31, 1988 were clinically analyzed. The results were as follows: 1. The incidence of ocular injuries was 4.7% of all eye patients, and 25.5% of all patients admitted to this ophthalmologic department. 2. The incidence was more common in male(76,8%)and in the age of 3rd to 4th decades(47.0%). 3. The ocular injuries were more common in the spring(27.3%), and in March. 4. The most common cause of ocular injuries was sand or dust or iron piece(29.8%), followed by fist or finger(12.2%) and traffic accident(12.5%), but the injuries by iron products(20.1%) were the most common in the admitted patients. 5. The most common ocular injury was conjunctival foreign body(23.7%), followed by subconjunctival hemorrhage (20.6%) and (9.5%). In the cases of in-patients, hyphema(24.2%) was the most coommon, followed by corneal lacera tion(12.2%) and eyelid laceration(11.2%). 6. Surgical procedure included corneal suture(18.3%), primary closure of eyelid and face(22.2%). 7. Visual acuity was improved in most cases by treatment, but the corrected vision after treatment was less than 0.1 in 20.5%, which was mainly due to the perforating eye injuries. 8. The most common complication of ocular injuries after treatment was corneal opacity(34.1%), followed by vitreous opacity(9.4%).

Ocular Injuries Caused by Windshield Damage

We studied clinically 33 in patients(48 eyes) of windshield ocular injuries among 72 in patients who had ocular injuries by traffic accidents and underwent surgical treatment in Department of Ophthalmology of Han Gang Sacred Heart Hospital from 1. Jan, 1980 to 31. July, 1987. The results of analysis were as follows: 1. The incidence of windshield ocular injuries was 45.8% of all the ocular injuries caused by traffic accident. 2. The incidence was more common in male(81.9%) and in the age of 4th decades(39.4%). 3. The incidence of bilateral ocular injuries was 45.3%. 4. The ocular injuries were more common in front right seats(54.5%) than driver's seats(45.5%). 5. Eyebll injuries occured in 77.1% and among them, corneoscleral laceration was most common. 6. There was no significant statiscal value of final visual acuity between laceration involvin the cornea only and laceration involving the cornea and anterior sclera. 7. Final V.A less than 0.1 was 43.7% and the most common cause of visual impairment was corneal opacity.