Demographic and Clinical Profile of Ocular Chemical Injuries in the Pediatric Age Group

Abstract

To review the risk factors, management, and visual outcomes of pediatric chemical eye injuries in a tertiary care hospital in North India. Retrospective hospital-based study. Patients aged <16 years with ocular chemical burns. Case records of patients with ocular chemical injury who presented to the Dr. Rajendra Prasad Centre for Ophthalmic Sciences were reviewed over a 5-year period. Demographic profile, nature of chemical injury, complications, and visual outcomes after chemical injury. A total of 134 pediatric patients with a history of ocular chemical burns were seen between March 2006 and March 2011. The mean age of patients at the time of injury was 8.95±4.89 years (range, 1.2-15.5 years); 63.4% were male. Sixty-nine patients (51.4%) belonged to the preschool (0-5 years) age group. Bilateral chemical injuries were seen in 24 patients (17.9%). Lime ("chuna") was the most commonly involved chemical (88, 65.6%) followed by toilet cleaner (20, 14.9%). The mean time between injury and presentation was 68.3 days (range, 1-365 days). Severe (grade 3 and 4) ocular chemical injury was seen in 94 patients (70.1%). Surgical intervention was performed in 114 eyes (85%) in the form of amniotic membrane grafting (n= 78), symblepharon release (n= 56), limbal stem cell transplantation (n= 26), and lamellar keratoplasty (n= 14). The average number of surgeries conducted per patient was 2.3 (range, 1-4). Median visual acuity at final follow-up (mean, 537±354 days) was 3/60. Chemical injuries in pediatric patients are more commonly encountered in the preschool age group and are associated with severe visual loss. Alkali injury from bursting of chuna packets was the most common mode of injury in pediatric patients in our study.