Research Article

An evaluation of visual outcome of corneal injuries in a tertiary care hospital

Aarudhra Premchander, Seema Channabasappa, Nischala Balakrishna* and Neha Nargis

Published: 09/09/2019 | Volume 3 - Issue 2 | Pages: 020-029

Abstract

Background: Corneal injuries are significant contributors to blindness. Cornea being the most anterior structure of eye is exposed to various hazards like airborne debris and blunt trauma. By understanding different types of injuries to which cornea is exposed, the practitioner maybe more capable in managing injuries to minimise structural and visual sequelae.

Objectives: To study various patterns of corneal injuries and its visual outcome among patients of ocular trauma in a tertiary care hospital. Methods: Study of 100 cases of corneal injuries wherein patients were treated according to injury type and followed up for 4 months.

Results: Majority of patients belonged to working population between age groups 21-65 years. Most patients suffered from corneal abrasions while the least common were perforating and lacerating injuries. Alkali injuries were more common than acid injuries. Most patient presented within 24 hours and had only epithelial defects. Therefore, the number of patients receiving conservative management was higher than those receiving surgical intervention.

Conclusion: Most common causes of blindness and low vision in our study was full thickness corneal laceration and corneal abrasions, foreign body injuries affecting the pupillary area and involving anterior or mid stroma causing nebular or macular grade opacities hampering vision.

Read Full Article HTML DOI: 10.29328/journal.ijceo.1001022 Cite this Article

References

  1. Krachmer, Mannis and Holland: Book of Cornea; Second Edition 2005:Volume1; Section 8-Corneal Trauma; Chapter 100: Mechanical Injury. 1245.
  2. Thylefors B, Negrel Ad, Pararajasegaram R, Dadzie Ky. Global data on blindness. Bull Who.1995; 72:115. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/7704921
  3. Upadhyay MP, Karmacharya PC, Koirala S, Shah DN, Shakya , et al. The bhaktapur eye study: ocular trauma and antibiotic prophylaxis for the prevention of corneal ulceration in Nepal. Br J Ophthalmol. 2001; 85: 388-392. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1723912/
  4. Rao GN. Corneal opacification in the developing world Chapter 61.
  5. Dandona R, Dandona L. Corneal blindness in a southern indian population: need for health promotion strategies. Br J Ophthalmol. 2003; 87:133-141.
  6. Sinha R, Sharma N, Rasik B. Vajpayee. Corneal blindness present status. Tackling World Blindness. 2005; 61.
  7. Krachmer, Mannis and Holland: Book of Cornea; Second Edition 2005: Volume 1; Section 8-Corneal Trauma; Chapter 100: Mechanical Injury: Pg 1246.
  8. Krachmer, Mannis and Holland: Book of Cornea; Second Edition 2005: Volume 1; Section 8-Corneal Trauma; Chapter 100: Mechanical Injury: Pg 1256.
  9. Adhikari RK. Analysis of corneal injuries in king mahendra memorial eye hospital Bharatpur, Chitwan. Kathmandu Univ Med J (KUMJ) 2006; 4: 34-39. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18603865
  10. Macewen CJ. Glasgow eye infirmary, eye injuries a prospective survey of 5671 cases. Br J Ophthalmol. 1989; 73: 888-894. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2605143
  11. Chiapella AP, Rosenthal AR. One year in an eye casualty. Br J Ophthalmol. 1985; 69: 865-870. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/4063253
  12. Monestam E, Bjornstig. Eye injuries in northern sweden. Acta Ophthalmol. 1991; 69: 1-5.
  13. Banerjee A. Effectiveness of eye protection in the metal working industry. BMJ. 1990; 301: 645-646. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1663866/
  14. Kuckelkorn R, Kottek A, Schrage N, Reim M. Poor prognosis of severe chemical and thermal eye burns: the need for adequate emergency care and primary prevention. Int Arch Occup Environ Health.1995; 67: 281-284. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/7591189
  15. Benjamin DA, Qian Garrett, Mark W. Corneal injuries and wound healing –review of processes and therapie. Austin Journal of Clinical Ophthalmology. 2014; 1:1-25.
  16. Kuckelkorn R, Luft I, Kottek AA, Schrage NF, Makropoulos W, et al. Chemical and thermal eye burns in the residential area of rwth aachen. Analysis of accident in 1 year using a new automated documentation of findings. Klin Monbl Augenheilkd. 1993; 203: 34-42. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8411890
  17. Kuckelkorn M, Makropoulos W, Kotteck A, Reim M. Retrospective study of severe alkali burns of the eyes. Klin Monatsbl Augenheikd. 1993; 203: 397-402. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8145483
  18. Das S, Kabir MF, Das J. Pattern of chemical ocularinjury: a clinical study, Chattagram Maa-O-Shishu Hospital Medical College. Journal. 2014; 13: 42-45.
  19. McCulley JP. Ocular hydrofluoric acid burns: animal model, mechanism of injury and therapy. Transam Ophthalmol Soc. 1990; 88: 649-684. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1298602/
  20. Whitcher JP, Srinivasan M, Madan P, Upadhyay. Corneal blindness: a global perspective. Bull World Health Organ. 2001; 79: 214-221. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11285665
  21. Pfister RR, Koski J. The pathophysiology and treatment of the alkali-burned eye. South Med J. 1982; 75: 417-422.
  22. Friedenwald JS, Hughes WF, Hermann H. Acid-base tolerance of the-cornea. Arch Ophthalmol. 1944; 31: 279-283.