Demographic, Clinical Profile and Management Outcomes of Ocular Chemical Injuries in Saudi Children

Abstract

Background Eye injuries in children due to chemicals constitute a medical emergency since they result in severe ocular damage. Objective To determine the factors and management outcomes of chemical burns in the eyes of Saudi children. The study was performed at a tertiary eye center in the Kingdom of Saudi Arabia. Methods Children aged 16 years and under who had ocular chemical burns from 2009 to 2021 were enrolled in a single-armed cohort study. Data collection was done on patient demographics, injury type, and previous treatment. A modified Roper-Hall classification was used to grade the ocular injuries. The research study revealed the outcome to be best-corrected visual acuity (BCVA), one year after presentation and management. Results This study included 185 eyes from 147 children with chemical burns. The main profile of this study comprised the following categories: male (72.1%), grade 4 injury (27.6%), injury by acid (57.1%), burns at home (66%), and first aid was given to (35.4%) of the children. One year after treatment, there were 58 (31.4%) eyes with BCVA from 20/20 to 20/60, 31 cases (16.8%) with BCVA from 20/60 to 20/200, and 86 (46.5%) cases with severe visual impairment (SVI). Treatments included the release of symblepharon in 34 (18.4%) eyes and amniotic membrane transplantation (AMT) in 27 (14.6%) eyes. Poor visual outcomes were correlated with chemical burn severity (RR = 1.45, P =0.04). First aid administration ( P = 0.86) and type of chemical (acid vs non-acid) ( P = 0.83) did not differ significantly in association with SVI at the one-year follow-up. Conclusion Visual outcomes of chemical burns in children were not promising even after one year of treatment. Public health initiatives are critical to prevent chemical burns in mitigating the poor visual prognosis.

An Indian epidemiological overview of ocular emergencies of the year 2022

“…One of the notable differences between our study and the others is the higher percentage of male patients (55.9%) in our sample, which is consistent with previous reports from India [1]. In contrast, some studies from the U.S. [20,22] and Saudi Arabia [27] reported a more balanced sex ratio or even a slight female predominance. This may also re ect the different sociocultural factors and occupational exposures that affect the risk of ocular injuries in different populations.…”

“…We also observed that most of our patients were from rural areas (70%), which is in contrast to the ndings of some studies from China [2,3] and Saudi Arabia [27]. Studies have shown that urban residents in India are more likely to sustain ocular injuries due to better access to eye care services and fewer risk factors, such as agricultural work and reworks.…”

“…The most common cause of ocular injuries in our study was trauma (32.8%), followed by infection/in ammation (34.5%) and glaucoma (24.7%). Trauma was also the leading cause of ocular injuries in most of the other studies we reviewed [20][21][22]27]. except for Gomes et al [24], who reported that keratoconus was the most prevalent eye disease in their sample from Brazil.…”

Toxic External Exposure Leading to Ocular Surface Injury

“…Chemical burns to the eye can come from acids, alkalis, or alcohol ( Table 1 ) [ 183 ]. Acids cause protein coagulation, which somewhat limits damage by forming a self-containing barrier while alkalis are lipophilic, cause saponification and penetrate more deeply into tissue, leading to extensive and severe damage to the cornea [ 184 , 185 ]. Alkali burns can result in loss of limbal epithelial stem cells that are essential for regeneration of corneal epithelium [ 186 ].…”

Community-Level Awareness of Proper Immediate Steps Regarding Ocular Chemical Injury in Qassim Region, Saudi Arabia

“…Numerous investigations have evaluated the comprehensive prevalence and causation of ocular chemical damage. According to a meta-analysis conducted in 2021, the reported incidence rate of the condition ranged from 5.1 to 50 per 100,000 individuals’ year across multiple nations [ 9 ]. There exists a concept positing that despite the potential for vision impairment resulting from such injuries, there is a notable dearth of awareness within the community [ 10 ].…”