Clinical Profile of Ocular Chemical Injuries in a Tertiary Care Centre of Kolar, Karnataka, India: A Retrospective Study

Abstract

Introduction: Ocular chemical injury is a true ophthalmic emergency which needs immediate assessment and management. They cause extensive damage to the ocular surface resulting in permanent visual impairment. The majority of victims are young and the exposure occurs at home, work place and with assaults. Aim: To analyse the clinical characteristics, grade and visual outcome in patients with ocular chemical injuries. Materials and Methods: This retrospective study was conducted on patients with chemical eye injuries who presented at Ophthalmology Department in Kolar tertiary care centre in the past five years. Medical records of 127 patients who presented from January 2017 to December 2021 with chemical eye injuries were assessed for age, gender, history of the mode of injury, pattern and grade of damage, visual outcome and treatment methods during the acute phase and at one month follow-up. Paired t-test and one-way Analysis of Variance (ANOVA) with post-hoc test was the statistical method used for analysis. Results: Out of 127 chemical injury cases, 104 (81.9%) were males and 23 (18.1%) were females. The incidence of chemical injury was found to be 51 (40.2%) in the age group of 31-45 years and 38 (29.9%) in 15-30 years with 74 (58.3%) cases affected by alkali and 27 (21.3%) cases by acids and 26 (20.4%) unknown injury. A total of 43 (34%) cases had grade I, 75 (59%) had grade II and 9 (7%) had grade III injury and the common clinical finding was conjunctival congestion in 147 (93.6%) and epithelial defect in 107 (68.1%). Significant improvement in the visual acuity was observed after the initial management and subsequently at one month follow-up (p-value<0.001). Conclusion: Male dominance and fields and workplace injuries were most common in the study. Initiation of immediate irrigation with tap water and early reporting to the hospital can reduce serious complications with early restoration of vision. It also emphasises the promotion of necessary protective measures to avoid workplace based accidental injuries.