open access

Vol 6 (2021): Continuous Publishing
Original paper
Published online: 2021-10-27
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Acute ocular chemical injury: a descriptive assessment and management review at St. John Eye Hospital, Jerusalem, Palestine

Riyad Banayot1, Yahya Swaiti1, Islam Al-hashash1
·
Ophthalmol J 2021;6:171-177.
Affiliations
  1. St. John Eye Hospital, Jerusalem, Palestine

open access

Vol 6 (2021): Continuous Publishing
ORIGINAL PAPERS
Published online: 2021-10-27

Abstract

Background: The purpose of the study was to assess caregivers’ compliance with the management protocol for chemical injury at St. John Eye Hospital, Jerusalem.

Material and methods: Charts of all new chemical injury patients who presented to St. John Eye Hospital, Jerusalem, between January and December 2019 were retrospectively reviewed. Data categories collected included: presentation, age, sex, injury, irrigation, lids, visual acuity, slit-lamp examination (SLE), management plan, and medications given. Data were stored and analysed using Excel.

Results: Patients’ presentation date and time, sex, and age were recorded in over 90% of cases. The mechanism of injury and type of offending chemical were recorded in 65% of cases. The irrigating solution was identified in 50% of cases. Corrected visual acuity was recorded in both eyes in almost 50% of cases. Limbal ischemia was documented in 45% of cases, and intraocular pressure (IOP) was recorded in 25%. The management plan and explanation of the condition to patients were documented in less than 50% of cases. Antibiotics and steroids (drops/ointment) were prescribed in 92.5% of cases.

Conclusions: The results of this study reveal that our documentation needs improvement for several parameters. Several recommendations were formulated:

  1. Emphasize to caregivers that irrigation must be done first.
  2. Corrected visual acuity should be attempted for both eyes in all cases, and reasons for not recording it should be documented.
  3. It is important to document and record limbus details, iris details, and IOP in all cases.

Abstract

Background: The purpose of the study was to assess caregivers’ compliance with the management protocol for chemical injury at St. John Eye Hospital, Jerusalem.

Material and methods: Charts of all new chemical injury patients who presented to St. John Eye Hospital, Jerusalem, between January and December 2019 were retrospectively reviewed. Data categories collected included: presentation, age, sex, injury, irrigation, lids, visual acuity, slit-lamp examination (SLE), management plan, and medications given. Data were stored and analysed using Excel.

Results: Patients’ presentation date and time, sex, and age were recorded in over 90% of cases. The mechanism of injury and type of offending chemical were recorded in 65% of cases. The irrigating solution was identified in 50% of cases. Corrected visual acuity was recorded in both eyes in almost 50% of cases. Limbal ischemia was documented in 45% of cases, and intraocular pressure (IOP) was recorded in 25%. The management plan and explanation of the condition to patients were documented in less than 50% of cases. Antibiotics and steroids (drops/ointment) were prescribed in 92.5% of cases.

Conclusions: The results of this study reveal that our documentation needs improvement for several parameters. Several recommendations were formulated:

  1. Emphasize to caregivers that irrigation must be done first.
  2. Corrected visual acuity should be attempted for both eyes in all cases, and reasons for not recording it should be documented.
  3. It is important to document and record limbus details, iris details, and IOP in all cases.
Get Citation

Keywords

chemical injury; protocol; assessment; management; Palestine

About this article
Title

Acute ocular chemical injury: a descriptive assessment and management review at St. John Eye Hospital, Jerusalem, Palestine

Journal

Ophthalmology Journal

Issue

Vol 6 (2021): Continuous Publishing

Article type

Original paper

Pages

171-177

Published online

2021-10-27

Page views

6157

Article views/downloads

369

DOI

10.5603/OJ.2021.0032

Bibliographic record

Ophthalmol J 2021;6:171-177.

Keywords

chemical injury
protocol
assessment
management
Palestine

Authors

Riyad Banayot
Yahya Swaiti
Islam Al-hashash

References (10)
  1. Hughes WF. Alkali burns of the eye; clinical and pathologic course. Arch Ophthal. 1946; 36: 189–214.
  2. Lubeck D, Greene JS. Corneal injuries. Emerg Med Clin North Am. 1988; 6(1): 73–94.
  3. Cohen KL, Hyndiuk RA. Ocular emergencies. Am Fam Physician. 1978; 18(4): 178–184.
  4. Rodeheaver GT, Hiebert JM, Edlich RF. Initial treatment of chemical skin and eye burns. Compr Ther. 1982; 8(5): 37–43.
  5. Roper-Hall MJ. Thermal and chemical burns. Trans Ophthalmol Soc UK. 1965; 85: 631–653.
  6. Lin M, Ekşioğlu Ü, Mudumbai R, et al. Glaucoma in Patients With Ocular Chemical Burns. Am J Ophthalmol. 2012; 154(3): 481–485.e1.
  7. Wagoner MD. Chemical injuries of the eye: current concepts in pathophysiology and therapy. Surv Ophthalmol. 1997; 41(4): 275–313.
  8. McCulley JP. Chemical injuries. In: Smolin G, Thoft RA. ed. The Cornea: Scientific Foundation and Clinical Practice. Little Brown and Co, Boston 1987: 527–42.
  9. American Academy of Ophthalmology 2019, Chemical (Alkali and Acid) Injury of the Conjunctiva and Cornea. https://eyewiki.aao.org/Chemical_(Alkali_and_Acid)_Injury_of_the_Conjunctiva_and_Cornea (June 17, 2021).
  10. The Royal College of Ophthalmologists 2019. Chemical injuries of the ocular. https://www.rcophth.ac.uk/wp-content/uploads/2018/04/College-News-April-2018-Focus.pdf (June 17, 2021).

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