A study of ocular chemical injuries presenting to a tertiary eye centre in London, UK

Session Details

Session Title: Cornea Miscellaneous

Session Date/Time: Monday 24/09/2018 | 16:30-18:00

Paper Time: 16:54

Venue: Room A3, Podium 3

First Author: : M.Bizrah UK

Co Author(s): :    A. Yusuf   S. Ahmad                 

Abstract Details

Purpose:

To investigate the incidence, acute management and prognosis of ocular chemical injuries presenting to a tertiary ophthalmology centre in London.

Setting:

Moorfields Eye Hospital NHS Foundation Trust 162 City Road London EC1V 2PD

Methods:

All patients presenting to A&E are registered onto electronic Patient Administration System (PAS). Diagnosis and management is entered electronically, and written patient notes are also done for all patients. 'Chemical injury' is a set diagnosis on the PAS system. A search of 'Chemical injury' was performed on the PAS system for the pre-set period of 1st Jan 2016 to 31st March 2016. The electronic records and the handwritten casualty notes of all of these patients were reviewed. All required information was entered into Excel database for analysis.

Results:

84 patients were diagnosed with chemical injury; 11 were severe (Grade 2 or more on Roper Hall Classification) and 55 were mild. Average age was 35 years. Males constituted 53% and 81% of patients who had mild and severe chemical injuries, respectively. 36% of severe injuries were assault-related. First emergency service presentation was more than 24 hours post injury in 30% of patients with severe injuries. In severe chemical injury group, pH was >10 in 6 patients, 36% poorly complied with treatment, 25% did not tolerate sodium ascorbate eye drops, and 36% had Final BCVA was 6/18 or worse.

Conclusions:

Initial presentation Roper-Hall classification and visual acuity were found to be key prognostic factors for final visual acuity. Significant proportion of severe chemical injury were assault-related. Delayed presentation is a significant problem in patients with severe injuries. Immediate irrigation and emergency department attendance are therefore key public health messages. Poor emergency department re-attendance rates and poor treatment compliance (e.g. sodium ascorbate eye drops being stopped due to pain) are other key challenges. This raises the question of whether these patients, who are mostly young males, should be admitted to improve treatment compliance and visual outcomes.

Financial Disclosure:

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