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Bora Chae, Elisabeth J Cohen, Rachel M. Cymerman, Lisa Park; Epidemiology, clinical characteristics and complications in ocular foreign body injuries.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4713. doi: https://doi.org/.
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To evaluate the epidemiology, clinical characteristics and complications in ocular foreign bodies from patients presenting with the complaint of foreign body entering the eye in an urban hospital.
Ninety-nine cases from 1/2011 to 9/2013 were retrospectively reviewed and data regarding age, gender, prior history of foreign body, time elapsed from inciting event to presentation, work related injury, and the use of protective devices were collected. Clinical characteristics including type of foreign body, method of removal, and complications resulting from injury were examined. Complications of a corneal stromal haze or scar were analyzed in relation to the presence of a rust ring or an anterior chamber reaction.
There were a total of 1899 ophthalmologic consultations conducted from Jan 2011 to Sept. 2013 in the ER of a major New York City hospital. Ninety-nine patients presented with chief complaint of foreign body entering the eye and most were male (95%), in ages 31 to 40 (23%), with inciting event occurring less than 24 hours prior to presentation (56%), and with injury occurring during work often construction related (78%). Eighty-eight of these patients sustained injuries to the cornea. Out of the 61 patients who followed up, 8 had a documented decrease in vision (greater than 2 lines) in the injured eye. Major complications included a single case of a perforating corneal injury and one incident of an intraocular foreign body through a penetrating corneal wound in which removal in the OR was required. There were 4 cases of corneal infiltrate, 3 of them preceded by an AC reaction. The presence of a rust ring from a metallic foreign body did not have a statistically significant effect on the relative risk for developing a stromal scar or haze (RR=1.51, p=0.31 and RR=1.51, p=0.41). Data however shows a relative risk of 9.9 for developing a corneal stromal haze in patients who present with anterior chamber inflammation (p<0.0001).
Ocular foreign body was the cause of 5% of eye consultations conducted in an ER of a major urban hospital and of these cases, two major complications were seen which required management in the OR. The presence of an anterior chamber reaction was a risk factor for development of a corneal stromal haze. The presence of a rust ring did not have a statistically significant association with the development of stromal haze or scar in the cornea.
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