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R. Mudumbai, U. Eksioglu, A. Bhandari, P.P. Chen; Comparison of Glaucoma and Vision Characteristics of Patients with Severe, Moderate, and Mild Vision Loss From Ocular Chemical Burns . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5562.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe the glaucoma and vision characteristics of patients exposed to chemical burns of the eyes. Additionally, to identify whether severe vision loss at presentation is a risk factor for the development of glaucoma and to evaluate the visual prognosis of these patients. Methods: Retrospective, non–consecutive chart review of patients seen between 1997 and 2003 at the University of Washington Medical Center and Harborview Medical Center found to have either alkali burns (ALB) or acid burns (ACB) to the eyes with at least 3 months of follow up. Age, sex, and pH at presentation were noted. Vision loss was analyzed by stratifying loss as mild vision loss (MIVL– Snellen 20/20 – 20/50), moderate vision loss (MOVL – Snellen 20/60–20/100) and severe vision loss (SVL – Snellen worse than 20/100). Intraocular pressure (IOP) and number of glaucoma medications (GM) were recorded at various time points including presentation, 1 week, 1 month, 3 months and last follow up visit. Patients with SVL were compared to the MIVL/MOVL groups for IOP and need for GM. SVL group was also evaluated for improvement to MIVL or MOVL over the course of the study. Paired t–test was used for statistical analysis. Results: Results are displayed in the accompanying table. 25 eyes of 16 patients were identified with 75% male and mean age 47.38±17.27 years. Mean pH for ALB was 9.38. Patients with SVL had significantly higher IOP than MIVL/MOVL at presentation (31.50± 14.10 mmHg versus 15.43± 7.21 mmHg, p=0.003) and at 3 months (26.88± 10.70 mmHg versus 13.6± 6.27 mmHg, p=0.017) and required significantly more glaucoma medications throughout the study. Only one out of 14 SVL (7%) had visual improvement to MOVL. Conclusion: Patients with SVL require closer attention for the development of glaucoma as compared to MIVL or MOVL. Eyes with SVL at presentation were more likely to develop sustained elevated IOP, require more glaucoma medication and were unlikely to regain vision over the course of the study.
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