Clinical characteristics and visual outcome of severe ocular chemical injuries in Shanghai

Abstract

Objective: To study the clinical characteristics of patients with severe ocular chemical injury in Shanghai and to determine their relationship with visual outcome.

Design: Retrospective case series.

Participants: A total of 79 525 in-patients at Shanghai Eye, Ear, Nose, and Throat Hospital between 1998 and 2008.

Methods: Medical records of severe ocular chemical injuries were reviewed retrospectively. Patients' age, gender, occupation, location where injury occurred, the nature of chemical agent, complication, and visual acuity at final follow-up were described. The relationship between visual impairment and clinical characteristics was analyzed.

Main outcome measures: Estimated prevalence rate, demographics of patients, nature of injury, prognosis, and factors associated with visual impairment.

Results: The estimated prevalence rate in Shanghai of severe ocular chemical injury was 1.58 per 100,000. One hundred ninety cases with 239 eyes were identified for analyzing the clinical characteristics. The average age of all subjects was 35.3 ± 14.8 years with a male:female ratio of 6:1. Factory and construction worker (n = 141; 74.2% of total cases) were the most common occupations. Most of the accidents occurred at workplace (n = 144; 74.8%); the majority of injuries were caused by alkali agents (n = 129; 67.9%). Complications were found in 222 eyes (92.9%). A visual acuity of ≥ 6/60 was achieved only in 5 eyes (2.1%). In multivariate logistic regression analysis, being visually impaired was significantly associated with the patients' complication (P = 0.021).

Conclusions: The prevalence of severe ocular chemical injury in Shanghai is low. Most subjects needed surgery to restore visual function. Successful management provides a good prognosis for most patients.