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Monica Ertel, Alexander Port, Sandra Halim, Benjamin Levine; Ocular involvement among burn patients: does the type of burn matter?. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4803.
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© ARVO (1962-2015); The Authors (2016-present)
Facial and periocular burns are a common reason for emergency department evaluation and burn center admission. These burns are of particular interest to the ophthalmologist because burns involving the globe or its adnexa can result in sequelae that may compromise vision. In this study, we sought to analyze data on patients presenting with facial burns to understand which types of burns are more likely to result in ocular involvement and potentially effect vision.
Retrospective chart review of patients presenting to the William Randolph Hearst Burn Center at New York Presbyterian/Weill Cornell Medical Center who were evaluated by ophthalmology to assess for ocular involvement. Patients were grouped based on type of burn (scald, thermal or chemical) and the presence of ocular involvement (the globe and/or adnexa) or corneal involvement.
97 patients evaluated between October 2014 and December 2015 were included. The primary cause of burn injuries were thermal burns (n=52, 53%), scald burns (n=33, 34%) and chemical burns (n=12, 12%). Ocular involvement was present in 78.8% of thermal-burn patients, 78.8% of scald-burn patients, and 91.7% of chemical burn patients. There was no statistically-significant difference in the rate of ocular involvement between the thermal, scald, and chemical burn groups on ANOVA analysis (p = 0.5847). Corneal involvement was seen in 15.3% of scald-burn patients, 30.8% of thermal burn patients and 75.0% of chemical burn patients; this difference was statistically significant on ANOVA analysis (p=0.0004). Further analysis revealed a statistically higher rate of corneal involvement in the chemical group versus the thermal group (Difference: 44.24%, chi-squared: 7.892, p=0.005) and compared to the scald-burn group (difference: 59.85%, chi-squared: 14.381, p=0.0001). Chemical burns were associated with greater risk of corneal involvement (OR = 0.3294, 95% CI: 0.1227 to 0.8843, p = 0.0275).
There is a high rate of ocular involvement when ophthalmology consults are requested to evaluate patients with facial burns in a tertiary care center. Patients with chemical burns of the face are significantly more likely to have corneal involvement than patients with scald or thermal burns. Ophthalmologists should have a high index of suspicion for ocular involvement and should pay particular attention to the cornea examination in patients with chemical burns.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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