Eye injuries caused by date palm thorns and leaves

Abstract

Purpose: To describe the clinical presentation, management, and outcome of hospitalized patients having date palm tree eye injuries.

Methods: This is a retrospective study of consecutive patients who were admitted to Al-Ain hospital following date palm tree eye injuries between 2012 and 2017. Patients' demography, symptoms and signs at presentation, surgical intervention, visual acuity (VA) before and after treatment, hospital stay, and causes for VA limitation were studied.

Results: Sixteen patients were studied. Their median (range) age was 38.5 (7-58) years, all were males. Majority (87.5%) were from the Indian subcontinent and had their injuries at farms. Eye pain (94 %) was the most common presenting symptom while keratitis (62.5%) and corneal perforation (43.8%) were the most common physical findings. Vision showed a statistical trend for improvement after treatment (P = 0.1, Wilcoxon singed rank test). Five patients (31%) were blind in the injured eye.

Conclusion: Palm date tree eye injuries which mainly occur at farms are a significant cause for visual loss at United Arab Emirates (UAE). Use of eyes protective goggles combined with legislative eye safety regulations will reduce palm tree eye injuries.

Keywords: Corneal ulcer; date palm; eye injuries; penetrating injury; thorn.

Figure 1

Date palm tree thorns (a). A laborer climbing the date palm tree with a rope passed behind the trunk of the tree and his back (b)

Figure 2

Time between injury and hospital presentation of 16 patients who had date palm tree eye injuries and required hospitalization in Al-Ain Hospital during the period of 2012–2017

Figure 3

Coronal (a) and sagittal (b) computed tomography (CT) scan with intravenous contrast of the right orbit of a 35-year old male farmer who sustained a right eye injury caused by a date palm tree thorn. It shows subcutaneous emphysema (white arrow), defect of the sclera (yellow arrow), and the tract of the penetrating injury (arrow head)

Figure 4

The initial and final visual acuity of 16 patients who had date palmtree eye injuries and required hospitalization during the period of 2012-2017. There was a strong trend for improvement of visual acuity at follow up (P = 0.1, Wilcoxon signed rank test)

Figure 5

A 65-year-old man sustained a right eye injury caused by a date palm tree thorn which is embedded in the central region of the cornea (Courtesy of Dr. Saeed Akhter Chohan, FRCS, Fujairah Hospital, Fujairah, United Arab Emirates)