Severe ocular chemical injury at a London ophthalmic referral hospital: a three-year retrospective observational study

Session Details

Session Title: Cornea: Medical

Session Date/Time: Tuesday 10/10/2017 | 08:00-10:30

Paper Time: 08:06

Venue: Room 3.6

First Author: : J.Hoffman UK

Co Author(s): :    E. Casswell   A. Short                 

Abstract Details

Purpose:

Severe ocular chemical injuries (SOCI) can result in significant morbidity and visual loss. Previous studies estimated that the incidence of SOCI is low. Anecdotal evidence suggests this incidence is increasing. This study reviewed the aetiology, management and outcome of all SOCI cases presenting to Moorfields Eye Hospital over three years.

Setting:

Moorfields Eye Hospital, London, UK: a tertiary referral ophthalmic hospital which sees over 100,000 emergency cases per annum.

Methods:

Retrospective observational study. All cases of SOCI presenting between 1st September 2011 and 31st August 2014 were identified. The definition of SOCI was grade 3 or 4 on the Hughes-Roper-Hall classification system (total loss of corneal epithelium, corneal haziness obscuring iris detail or worse and over 120 degrees of limbal ischaemia). The main outcome was number of cases per year. Secondary outcomes included the characteristics and mechanism of the injury, initial and long-term management, visual outcome and the need for surgical intervention.

Results:

We identified 25 cases (6 in 2011-12, 8 in 2012-13, 11 in 2013-14). Median age was 31.1 years. 23 cases (92%) were male. Assault was responsible for 16 (64%) cases, whilst 8 (32%) cases were work-related. The causative agent was known to be alkali in 15 (60%) of cases and unknown in 6 (24%). Cases were irrigated within 1 hour in 55% cases. The mean number of clock hours of limbal ischaemia was 5.24 (SD 2.97). 17 (68%) cases were Hughes-Roper-Hall grade 3. Surgical intervention occurred in 3 cases. BCVA in 44% of cases was worse than 6/12.

Conclusions:

The number of cases of SOCI presenting to our institution increased each year. Assault was a significant cause and our results suggest a large increase from the 33.3% of cases attributed to assault in the 2009 BOSU report. There is still a delay to irrigation in nearly half of cases.

Financial Disclosure:

NONE