Corneal injury by anti-misting agent in swim goggles: a case report

Short-term effects of two types of goggles on intraocular pressure and anterior eye segment biometrics

Background

To evaluate and compare the changes in intraocular pressure and anterior eye segment biometrics during and after wearing two types of commonly used swimming goggles.

Methods

In a cross-sectional study, a total of 40 healthy adults aged between 18 and 60 years old were selected to wear two kinds of common swimming goggles (ocular socket and orbital goggles). Intraocular pressure and anterior segment biometry were evaluated before wearing, at 2 and 5 min of wearing, and at 5 min after removing the goggles. Intraocular pressure (IOP), corneal front keratometry values (K1, K2, Km), central corneal thickness (CCT), central anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle (ACA) were measured.

Results

The IOP at 2 min (21.0 ± 2.2 mmHg) and 5 min (21.2 ± 2.3 mmHg) was significantly higher than before wearing goggles (17.7 ± 2.1 mmHg). The IOP after the goggles were removed and at 5 min after the goggles were removed was 18.4 ± 2.3 mmHg and 17.7 ± 2.1 mmHg, respectively. ACV, ACD, and ACA values all decreased while the googles were worn. After the goggles were removed, these changes gradually returned to baseline values, with no significant difference in the values before and after.

Conclusion

This study proves that wearing orbital goggles can lead to an acute increase in IOP and a slight decrease in ACV, ACD, and ACA. However, once the goggles are removed, these indicators return to baseline levels, showing that wearing orbital goggles has no significant lasting effect on IOP and anterior segment parameters.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12886-022-02308-y.

Ocular chemical burn associated with gel type alcohol-based hand sanitizer: A case report

INTRODUCTION

Alcohol-based hand sanitizers (ABHS) are widely used for hand hygiene due to the coronavirus disease pandemic. However, risk awareness regarding its adverse effects is lacking. We aim to report a case of ocular chemical burn that showed severe clinical presentation associated with ABHS.

PATIENT CONCERNS

A 5-year-old girl presented with severe left eye pain after 62% gel-type ABHS splashed into her eye.

DIAGNOSIS

On slit lamp examination, a near total corneal and conjunctival epithelial defect with limbal pale on the lower half of the cornea was noted. Severe ocular burn by ABHS was prominent with suspected limbal stem cell damage.

INTERVENTIONS

She was hospitalized and was prescribed topical medications including antibiotics, steroid eye drops with preservative-free artificial tears, and oral nonsteroidal anti-inflammatory drugs.

OUTCOMES

Despite intensive medical treatments, the corneal and conjunctival epithelial defects showed no improvement up to the 4th hospital day. After additional instillation of autoserum eye drops to promote epithelial healing, the corneal epithelium barely recovered from the temporal limbus. On the third week of admission, the epithelial defect was completely resolved without corneal opacity, although with minimal symblepharon in the lower fornix.

CONCLUSIONS

Gel-type ABHS can cause severe form of ocular chemical burn such as delayed ocular surface healing. In clinical setting, immediate and thorough rinsing of alcohol-based gel and early intensive treatment are crucial.

Toxic Keratoconjunctivitis

Toxic keratoconjunctivitis (TK) is an underrecognized complication of ophthalmic drug use and various environmental or occupational exposures. A detailed history and clinical examination are important to identify the offending agent(s). Common drug-related causes of TK include preservatives in ophthalmic medications, topical antimicrobials, and topical anesthetics. Alternatives to benzalkonium chloride as well as preservative-free formulations should be considered in patients requiring long-term topical medication. More advanced cases of TK may require preservative-free topical steroids and/or antibiotics, and occasionally surgical intervention. Early recognition and appropriate management of TK may help prevent permanent ocular and visual damage.

The impact of triathlon training and racing on athletes' general health

Although the sport of triathlon provides an opportunity to research the effect of multi-disciplinary exercise on health across the lifespan, much remains to be done. The literature has failed to consistently or adequately report subject age group, sex, ability level, and/or event-distance specialization. The demands of training and racing are relatively unquantified. Multiple definitions and reporting methods for injury and illness have been implemented. In general, risk factors for maladaptation have not been well-described. The data thus far collected indicate that the sport of triathlon is relatively safe for the well-prepared, well-supplied athlete. Most injuries 'causing cessation or reduction of training or seeking of medical aid' are not serious. However, as the extent to which they recur may be high and is undocumented, injury outcome is unclear. The sudden death rate for competition is 1.5 (0.9-2.5) [mostly swim-related] occurrences for every 100,000 participations. The sudden death rate is unknown for training, although stroke risk may be increased, in the long-term, in genetically susceptible athletes. During heavy training and up to 5 days post-competition, host protection against pathogens may also be compromised. The incidence of illness seems low, but its outcome is unclear. More prospective investigation of the immunological, oxidative stress-related and cardiovascular effects of triathlon training and competition is warranted. Training diaries may prove to be a promising method of monitoring negative adaptation and its potential risk factors. More longitudinal, medical-tent-based studies of the aetiology and treatment demands of race-related injury and illness are needed.