ASSESSMENT OF VISUAL PROGNOSIS IN PATIENTS WITH OCULAR BURNS: A CROSSSECTIONAL STUDY

Abstract

Introduction: Ocular burns are ophthalmic emergencies due to their visual morbidity. The extent of ocular surface involvement at the time of presentation is critically associated with visual outcome. Comprehensive ocular examination and prompt management is needed to optimize visual outcome. Objective: This study aims to evaluate the epidemiological trends, clinical features of patients with ocular burns and to determine their relationship with visual outcome. Methods:This prospective, cross-sectional study was conducted on 96 consecutive in-patients who were admitted in the Department of Plastic surgery and Burns in our hospital and sought opinion for ocular burns, irrespective of age and sex. The main outcome measures evaluated were clinical features of ocular burns and prognostic factors associated with visual impairment. Results: In our study, the mean age (S.D.) of patients was 32.83+/- 18.70 years with both males and females equally affected. The most common mode of injury was thermal injury due to domestic accidents (88.5%). 74% of patients had bilateral ocular presentation. Lid burns (42.2%) and lid edema (41.1%) were the most common ocular findings. About 5.2% of eyes showed corneal involvement. About 14 eyes (7.3%) had severe ocular complications among which one eye developed phthisis bulbi. 20 eyes (16.1%) had visual acuity of less than 6/60 causing visual morbidity. In multivariate logistic regression analysis, corneal involvement (p<0.001) and ocular complications (p=0.011) had a significant association with visual impairment. Conclusion:Corneal involvement and ocular complications are less common in facial burns due to Bell's phenomenon and protective blink reflex. However, both factors had a significant influence on visual outcome contributing to visual prognosis. Early intervention and adequate management will lead to favorable visual outcome.