ESCRS - PO0794 - Acute Ocular Chemical Injuries: Causes, Severity And Management In Emergency Unit Of A Portuguese Tertiary Eye Center

Acute Ocular Chemical Injuries: Causes, Severity And Management In Emergency Unit Of A Portuguese Tertiary Eye Center

Published 2023 - 41st Congress of the ESCRS

Reference: PO0794 | Type: Free paper | DOI: 10.82333/wn2z-7w38

Authors: Rita Rodrigues* 1 , Sara Perestrelo 1 , Raul Moreira 1 , Luís Torrão 1 , João Pinheiro-Costa 1 , Pedro Neves Cardoso 1 , Ana Maria Cunha 1

1Ophthalmology Department,Centro Hospitalar Universitário de São João,Porto,Portugal

Purpose

To characterize the incidence, nature, injury severity and management of acute ocular chemical injuries (AOCI) in a tertiary eye emergency unit (EEU).

Setting

Ophthalmology Emergency Department of Centro Hospitalar Universitário de São João, Porto, Portugal.

Methods

Medical records from adult patients with AOCI who attended EEU of Hospital de São João between 1st January 2022 and 1st January 2023 were reviewed. During the study period 16.714 adult patients attended EEU of Hospital de São João, 226 of which presented with AOCI, representing an estimated annual incidence of 7,53 new cases per 100,000 population. 271 eyes from 226 patients were included in the analysis. Mean age of the included patients was 44,4 years (range 18-89, SD 16,5), 55% (124 patients) were male. Data regarding laterality, accountable chemical, injury severity, management and complications were recorded. Severity of corneal involvement and limbal ischemia was graded based on Roper-Hall classification (RH).

Results

Injuries presented bilaterally in 45 patients (20%) and resulted from domestic incidents in 132 patients. Alkalis were the most frequently implicated chemicals (152 eyes), associated with use of cleaning products in 36% of cases. 228 patients presented in the first 24 hours and 170 (63%) performed eye irrigation before EEU arriving. According to RH classification, 212 eyes were classified as grade I, 32 as grade II, 8 as grade III and 2 as grade IV. Grade IV injuries affected 2 eyes of the same patient, resulted from injury with wet cement and required amniotic membrane transplantation. Most of the AOCI were mild and managed with topical steroids in 241 eyes, topical antibiotics in 256, artificial tears in 206 and topical vitamin A in 43.

Conclusions

Presented data underlines the importance of AOCI in both male and female young adults, prone to have domestic incidents related to cleaning activities and alkalis exposure in the studied population. The need for public health measures to promote health literacy regarding immediate irrigation after ocular chemical injury is emphasized by the low number of patients who performed irrigation after sustaining the injury. Roper-Hall grading system presents a valuable resource in prognosis prediction. The majority of AOCI observed in our EEU were minor and had favorable outcomes with immediate irrigation and appropriate topical treatment, although careful consideration should be given to severe corneal burns that require prompt suitable treatment.