September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Severe acute ocular chemical injuries – retrospective clinical audit of 38 consecutive new admissions in a tertiary hospital in the UK
Author Affiliations & Notes
  • Borja Salvador-Culla
    Ophthalmology, Royal Victoria Infirmary, Newcastle Upon Tyne, Boston, Massachusetts, United States
  • Jeffry Hogg
    Ophthalmology, Royal Victoria Infirmary, Newcastle University, Newcastle Upon Tyne, United Kingdom
  • Arthur Okonkwo
    Ophthalmology, Royal Victoria Infirmary, Newcastle University, Newcastle Upon Tyne, United Kingdom
  • Julie Mulroy
    Ophthalmology, Royal Victoria Infirmary, Newcastle Upon Tyne, Boston, Massachusetts, United States
  • Gustavo S Figueiredo
    Ophthalmology, Royal Victoria Infirmary, Newcastle University, Newcastle Upon Tyne, United Kingdom
    Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
  • Francisco C Figueiredo
    Ophthalmology, Royal Victoria Infirmary, Newcastle University, Newcastle Upon Tyne, United Kingdom
    Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
  • Footnotes
    Commercial Relationships   Borja Salvador-Culla, None; Jeffry Hogg, None; Arthur Okonkwo, None; Julie Mulroy, None; Gustavo Figueiredo, None; Francisco Figueiredo, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3056. doi:
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      Borja Salvador-Culla, Jeffry Hogg, Arthur Okonkwo, Julie Mulroy, Gustavo S Figueiredo, Francisco C Figueiredo; Severe acute ocular chemical injuries – retrospective clinical audit of 38 consecutive new admissions in a tertiary hospital in the UK. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3056.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe the clinical outcomes, management and socio-economical consequences of severe ocular chemical burns that required admission to a tertiary hospital

Methods : Retrospective review of all consecutive cases with severe ocular chemical injuries that were admitted to the Royal Victoria Infirmary eye ward between April 2013 and September 2015. Thirty-seven patients were included; demographics, visual acuity, type of injury, rate of limbal stem cell deficiency (LSCD), management and socio-economic data were evaluated

Results : Mean age on admission was 34.5 years (median 29; range 16-82; SD 16.1); 30 male (81.1%) and 19 bilateral cases (51.4%). Causative agent: alkali in 30 cases (81.1%), acid in 3 cases (8.1%), and unknown in 4 cases (10.8%). Fifteen cases (40.5%) were assaults, 11 (29.7%) were accidents at work, 9 (24.3%) were domestic accidents and 3 (8.1%) were undetermined. Eleven patients (29.7%) were unemployed (10 assaults, 1 domestic), 19 (51.4%) were laborers (11 work-related, 4 domestic, 3 assaults, 1 unknown), 4 (10.8%) were students (2 domestic, 1 work-related, 1 assault), and 3 (8.1%) were retired (2 domestic, 1 assault). Mean admission time was 4.3 days (median 3.5; SD 3.1; range 0-12). Mean follow-up time was 128.5 days (median 30; SD 223.6; range 1-796). Mean cost of admission was 2,478£ (median 2,125£; SD 1,496.9£; range 274-5,785£). Fifteen patients (40.5%) were lost to follow-up (8 assaults), 10 (27.1%) are returning, and 12 patients (32.4%) were discharged after being reviewed in clinic after discharge from the ward. These were mild chemical injuries that were admitted inadequately, probably after an initial incorrect assessment, with the consequent waste of resources. Five patients (7 eyes) (13.5%) developed total or partial LSCD, all being assaults (4 returning, 1 lost to follow-up).

Conclusions : Main causative agent herein was alkali, with men in the working age being most frequently involved. Many patients required prolonged hospital admission and lengthy follow-up. The majority of cases were assaults, closely followed by work accidents. A high proportion of assaults occurred in unemployed patients, with the majority being lost to follow-up. All the LSCD cases were assaults. We believe that the socio-economic environment plays an important role in the severity and the compliance to follow-up and treatment

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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