CHEMICAL INJURIES TO EYES

A TWO YEAR CLINICAL EXPERIENCE AT CMH HYDERABAD.

Abstract

Objective: To find out the chemical agents responsible for eye injuries,
assess magnitude of the problem and resultant visual outcomes in our dependent population. Design: Observational
study. Place and Duration of Study: Eye department, CMH, Hyderabad from Jan 2004 to Dec 2005. Patients and
Methods: Thirty five patients of all ages who presented with history of chemical injury to eyes during a period of two
years were included in this study. Patients with co-morbidity of eyes were not included. Cases were studied to find out
causative chemical agents and their nature, sex distribution, cause and place of the incident, duration of exposure (time
elapsed between chemical injury and copious irrigation at the time of presentation) and effect on visual function.
Results: Chemical injuries sustained by 47 eyes of 35 patients were analyzed. All of them were accidental and mostly
males were affected at their workplace. Nearly one third of the times 12(34.29%) both eyes were affected and
23(65.71%) cases were unilaterally affected. 30(85.72%) patients presented within first two hours of the injury.
3(8.57%) presented within 12 hours and 2(5.72%) presented within 24 hours. Severity of injury was grade I in most
eyes i.e. 37(78.73%) and grade II in 10(21.27%). None was found to have grade III or IV injury. Immediate irrigation
was reported in 29(82.86%) cases. The visual prognosis for eyes that received immediate irrigation was significantly
improved. 27(77.14%) cases were caused by alkalis and 8(22.86%) were due to acids. 26(74.28%) of the cases were
due to lime. A visual acuity of 6/6 was achieved in 40(85.10%) eyes at follow up after 01 week. 7(14.89%) eyes
developed corneal haze of varying degree resulting in BCVA of 6/9 to 6/18. Eye protection was not used in any of the
35(100%) cases. 1(2.13%) eye developed cataract during follow up period and needed to be operated upon for visual
rehabilitation. Conclusion: All ocular chemical injuries resulted from accidents; at work or at home and none resulted
from assault. Most of the injured persons needed to be hospitalized on an average for 03 days. Lime was found to be
the major culprit and was found to be used extensively for painting purposes. Visual outcome correlated with severity
of injury at initial presentation.