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Dag Y, Aydın S, Kumantas E. The profile of patients attending to the general emergency department with ocular complaints within the last year: is it a true ocular emergency? BMC Ophthalmol 2024; 24:330. [PMID: 39112942 PMCID: PMC11304559 DOI: 10.1186/s12886-024-03608-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 08/02/2024] [Indexed: 08/11/2024] Open
Abstract
PURPOSE Ocular emergencies require immediate intervention to prevent rapid vision loss or functional impairment. The aim of this study was to determine the proportion of true ocular emergencies among patients who presented to the general emergency department with ocular complaints and were referred to the Eye Clinic. METHODS In a retrospective cross-sectional study in a tertiary hospital in Istanbul, patients aged 0-100 years who presented to the general emergency department with ocular complaints between January and December 2022 were included. Inconclusive diagnoses and incomplete records were excluded. Patients were divided into three groups: top eye emergencies (TE), relative eye emergencies (REE), and non-emergency eyes (NEE). RESULTS Among the 652,224 individuals seeking care, 9,982 (1.5%) were referred to the Eye Emergency Clinic. Of these, 2,788 (27.9%) were female, and 7,194 (72.1%) were male, with ages ranging from 0 to 98 years. TopEye Emergencies (TEE), Relative Eye Emergencies (REE), and Non-Eye Emergencies (NEE) accounted for 13%, 60%, and 27% of the cases, respectively. Common top-eye emergencies (TEE) include chemical injuries, orbital-preseptal cellulitis, and orbital fractures. Relative eye emergencies (REEs) commonly feature corneal foreign bodies, corneal erosion, and conjunctivitis. Nonemulsion eye (NEE) methods involve simple eye redness, trauma without eye involvement, and subconjunctival haemorrhage. CONCLUSIONS Consistent with the literature, 1.5% of patients presenting to the general emergency department had eye complaints.However, 27% of those referred to the ophthalmological clinic did not have an urgent eye condition. This is partly due to the high proportion of patients presenting to the emergency department with ocular complaints and the lack of knowledge of ophthalmological diseases by emergency physicians, leading to unnecessary referrals to the ophthalmology clinic, resulting in a loss of the workforce and reduced time allocated to patients with true ocular emergencies.
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Affiliation(s)
- Yasar Dag
- Department of Opthalmology, Basaksehir Cam and Sakura City Hospital, İstanbul, Turkey.
| | - Seyfi Aydın
- Department of Opthalmology, Basaksehir Cam and Sakura City Hospital, İstanbul, Turkey
| | - Ebrar Kumantas
- Department of Opthalmology, Basaksehir Cam and Sakura City Hospital, İstanbul, Turkey
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Binczyk NM, Nazarali SA, Damji KF, Solarte C. Epidemiology of ocular emergencies in a large Canadian eye centre. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024; 59:e327-e330. [PMID: 37330216 DOI: 10.1016/j.jcjo.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 04/15/2023] [Accepted: 05/17/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE The Eye Institute of Alberta Emergency Eye Clinic (EIA EEC) is a tertiary eye care centre that provides emergency eye services to a population of more than 1 million. The purpose of this study was to describe the epidemiology of ocular emergencies at the EIA EEC. DESIGN Prospective epidemiologic study based on secondary use of patient data. PARTICIPANTS All patients seen in the EIA EEC on weekdays between July 2020 and June 2021. METHODS Charts were reviewed to obtain patient demographics, referral details, final diagnoses, need for imaging, emergency procedures, or further referrals. SPSS Statistics was used for data analysis. RESULTS A total of 2586 patients were seen over the study period. Most of the referrals (58%) were from emergency physicians. Optometrists and general physicians contributed 14% and 11% of referrals, respectively. Most referral diagnoses were related to inflammation (32%), and trauma (22%). Of all the cases of inflammation, 41% involved infection of the eye and 8% involved infection of ocular adnexa. In addition, 44% and 7% of cases involved noninfectious inflammation of the eye and adnexa, respectively. Frequently preformed emergency procedures were corneal or conjunctival foreign-body removal (39%) and corneal scraping (14%). CONCLUSIONS Continuing education related to emergency eye care may be most beneficial to emergency physicians, general practitioners, and optometrists. Educational opportunities could focus on most frequently seen diagnostic categories such as inflammation and trauma. Targeted public education aimed at preventing ocular trauma and infection, such as promoting wearing eye protection and practicing contact lens hygiene, may be beneficial.
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Affiliation(s)
- Natalia M Binczyk
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB
| | - Samir A Nazarali
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB
| | - Karim F Damji
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB.; Department of Ophthalmology and Visual Sciences, Aga Khan University, Karachi, Pakistan
| | - Carlos Solarte
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB..
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Kayoma DH, Oronsaye DA. Management of painful blind eye in Africa: A review. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2024; 14:245-248. [PMID: 38988421 PMCID: PMC11232782 DOI: 10.4103/jwas.jwas_164_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/11/2023] [Indexed: 07/12/2024]
Abstract
Background Painful blind eye conditions in Africa constitute a compelling area of concern within public health, presenting substantial complexities for healthcare systems and the individuals afflicted. This comprehensive review delves into recent research and advancements concerning the management of these conditions across the African region. Drawing upon contemporary studies and data, we scrutinise the multifaceted aspects, including prevalence rates, causative factors, and regional variations. Objective To review existing articles on the current state of the management of blind painful eye conditions in Africa. Materials and Methods Articles regarding the subject were obtained from Google Scholar, AJOL, and PubMed using the keywords, painful, blind eye (PBE), Africa. Results Forty-four relevant articles were reviewed. They were further categorized into epidemiology, management approaches and challenges to management. Conclusion The management of the PBE poses a huge challenge and can either be medical or surgical. Collaborative efforts should be targeted at preventing the causes of a PBE. As the burden of painful blind eye conditions continues to exert a profound impact across Africa, this article underscores the pressing need for collaborative efforts involving governments, non-governmental organisations, and international entities. By prioritising awareness and enhancing healthcare accessibility, we collectively strive towards the alleviation of suffering and the prevention of avoidable visual impairment in this region.
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Affiliation(s)
- Dumebi Hedwig Kayoma
- Department of Ophthalmology, University of Benin Teaching Hospital, Benin-City, Nigeria
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Kaur K, Srividya KS, Kabra N, Saranath R, Gurnani B, Venkatesh R. Patterns of ophthalmic emergencies presenting to a tertiary eye care hospital in India. Indian J Ophthalmol 2024; 72:296-297. [PMID: 38273691 PMCID: PMC10941940 DOI: 10.4103/ijo.ijo_1578_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Affiliation(s)
- Kirandeep Kaur
- Cataract, Pediatric Ophthalmology and Strabismus, Pondicherry, India
| | | | - Neha Kabra
- Fellow Cornea, and Refractive Services, Aravind Eye Hospital, Pondicherry, India
| | | | - Bharat Gurnani
- Cataract, Cornea, External Diseases, Trauma, Ocular Surface and Refractive Services, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
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ÇELİK DÜLGER S, ÇITIRIK M, BAHADİR CAMGOZ E, TEKE MY. Comparison of ocular emergencies in the COVID-19 pandemic and pre-pandemic period in the tertiary hospital of Turkey. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1099202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: To evaluate clinical characteristics and alterations in the of patients admitted to the ocular emergency department (ED) of a tertiary hospital during coronavirus disease period in 2019 (COVID-19) and pre-pandemic period. Also, we intended to share our strategy and experience to prevent disease transmission to health-care staff during patient submission.
Material and Method: In this study, 45901 patients who applied to ED between January and May in 2020 were reviewed retrospectively for ocular manifestations. The five months divided into two groups as the pre-pandemic period and the pandemic period. Clinical and demographic data were collected. The proportion of urgent and non-urgent cases in the pre-pandemic and pandemic period was compared.
Results: A total of 30,576 patients (66.6%) admitted to ED before COVID-19 and 15,325 patients admitted (33.4%) during COVID-19 era. Five hundred thirty-eight (1.8%) of cases admitted in the pre-pandemic period, and 395 (2.6%) of the cases admitted in the pandemic period were in the real urgent category. Conjunctivitis, blepharitis and hordeolum, dry eye diseases, corneal diseases were the most common conditions in both pre-pandemic and pandemic periods.
Conclusion: This study showed that admissions to ED for ocular conditions during the pandemic period decreased significantly, and the rate of real urgent cases increased. Yet even during the pandemic period, non-urgent patients continue to come to the ED.
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Affiliation(s)
| | - Mehmet ÇITIRIK
- UNIVERSITY OF HEALTH SCIENCES, ANKARA ULUCANLAR HEALTH RESEARCH CENTER
| | | | - Mehmet Yasin TEKE
- UNIVERSITY OF HEALTH SCIENCES, ANKARA ULUCANLAR HEALTH RESEARCH CENTER
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Sen P, Tripathi P, Mohan A, Agarwal K, Shah C, Parmar G, Sen A. Chemical injury with “packet of chunna” (lime) in children: A major ocular health concern in central rural India. JOURNAL OF CLINICAL OPHTHALMOLOGY AND RESEARCH 2022. [DOI: 10.4103/jcor.jcor_54_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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The Profile of Secondary Glaucoma in China: A Study of Over 10,000 Patients. J Glaucoma 2021; 30:895-901. [PMID: 34366389 DOI: 10.1097/ijg.0000000000001924] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 07/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few studies have investigated the epidemiology of secondary glaucoma (SG) in China. This study analyzed the current profile of admitted patients with SG at the largest ophthalmic center in China. METHODS SG cases were retrieved retrospectively by ICD-10 clinical coding data from January 2010 to December 2019. Demographic data, etiologies, and the management of SG were analyzed. The ratios of the etiologies were compared with previously reported data from other regions. The etiologies and management between the 2010 to 2014 group and the 2015 to 2019 group were compared. RESULTS A total of 11,730 cases were enrolled. The mean age of the patients with SG was 44.45±19.45 years old. Men (66.94%) were more vulnerable than women (33.06%). The etiologies of SG in 2010-2019 were trauma (28%), vascular disease (18%), lens-induced (9%), inflammation (11%), drug-induced (2%), anterior segment surgery (7%), posterior segment surgery (11%), syndrome-associated (4%), and tumors (1%). Compared with other regions, our data have a higher proportion of trauma and vascular disease-associated SG. Compared to 2010-2014, trauma-induced SG declined, and drug-induced SG, anterior segment surgery, and syndrome-associated SG increased in 2015-2019 (P<0.001). Vascular disease-associated SG cases were older than trauma-induced SCs and had a higher percentage in retired patients (P<0.001), whereas trauma-induced SGs were more prevalent in pediatric patients than vascular disease-related SGs (P<0.001). Additionally, the application of drainage device implantation, cataract surgery, and cyclophotocoagulation increased, whereas trabeculectomy and anterior chamber paracentesis and cyclocryotherapy decreased in 2015-2019 (P<0.005). CONCLUSION Although the etiology spectrum has changed during the last ten years, trauma and vascular disease are still common causes of SG in southern China. Traditional antiglaucoma surgery decreased gradually, and more advanced treatments emerged for its treatment. Up-to-date knowledge of SGs reflects the impact of economic development and ophthalmic service improvement on SGs and is of great value for ophthalmologists to detect SGs early and manage them in a timely manner.
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Ahmmed AA, Ting DSJ, Figueiredo FC. Epidemiology, economic and humanistic burdens of Ocular Surface Chemical Injury: A narrative review. Ocul Surf 2021; 20:199-211. [PMID: 33647471 DOI: 10.1016/j.jtos.2021.02.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 01/23/2023]
Abstract
Ocular surface chemical injury (OSCI) is a common type of ocular emergency that can potentially cause significant and permanent visual impairment. However, the global prevalence, demographic factors, socioeconomic burden, and psychological impact of OSCI have not been well investigated or reported. This review aims to provide a comprehensive overview of these aspects, highlight gaps in the literature, and advocate key strategies in reducing the incidence of OSCI. OSCI was responsible for 0.1-15% of all ocular emergency presentations, with an estimated incidence of 5.1-50 per 100,000 population-year. Young working adult men were the most at-risk group, though high rates of OSCI were also observed in young children in developed countries, especially from detergent pods. Low- and middle-income countries were noted to have higher proportions of assault-related and pediatric OSCI cases, often with more severe presentations. Direct and indirect costs for some hospitalized patients led to loss of all personal and household income after the injury. Emergency department costs in the United States were estimated at $106.7 million over four years and costs of treating long term complications such as glaucoma were estimated to be as high as $93,003 over five years. Significant negative impacts on visual and health-related quality of life and psychological well-being have been reported after injury, with higher rates of anxiety, depression, and psychological distress compared to the general population.
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Affiliation(s)
- Afsara A Ahmmed
- South Bristol Academy, Bristol Royal Infirmary, Bristol, UK; University of Bristol, Bristol, UK
| | - Darren Shu Jeng Ting
- Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK; Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK
| | - Francisco C Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK; Biosciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
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The Study of Incidence and Characteristics of Patients with Eye-Related Chief Complaints at the Emergency Department of Thammasat University Hospital. Emerg Med Int 2020; 2020:4280543. [PMID: 33133696 PMCID: PMC7591951 DOI: 10.1155/2020/4280543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/21/2020] [Accepted: 10/07/2020] [Indexed: 12/19/2022] Open
Abstract
Background Patients with eye-related chief complaints could be diagnosed not only with eye diseases but also with noneye diseases. This study determines rates and characteristics of patients with eye-related chief complaints at the Emergency Department of Thammasat University Hospital. Methods The study design is a descriptive retrospective observational study of patients with eye-related chief complaints at the Emergency Department of Thammasat University Hospital in 2017. Demographic data, diagnosis, management, consultation, and disposition were recorded by chart review. Categorical data were reported by percentage. Results Of the 52081 patients, 704 (1.3%) presented with eye problems. 60% of the patients were males. Patients were classified into three groups which are traumatic eye disease, nontraumatic eye disease, and noneye disease. 75.9% of the patients suffered traumatic injuries. The most common diagnoses of the traumatic eye injuries were foreign bodies at the cornea and conjunctiva and minor trauma to the conjunctiva. The most common mechanisms were foreign bodies in the eyes, cuts, or pierces. The most common causes of the injuries were from metals and housewares. The most common nontraumatic eye diagnoses were conjunctivitis and corneal ulcer. The most common noneye diagnoses were exposure of healthcare providers to secretions from patients, angioedema, and hypertensive crisis. Conclusions Most of the patients who came to the ER with chief complaints of the eyes could be treated by doctors in the emergency room without consulting ophthalmologists. Chief complaints of the eyes could be the leading symptoms of many organ systems. Emergency physicians should be differentially diagnosed to cover neurologic, cardiovascular, and immunologic problems.
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Salti HI, Mehanna CJ, Abiad B, Ghazi N, Raad S, Barikian A, Haddad R, Ashkar A, Harmouche E, Zaghrini E, Mufarrij A. Changing Trends in Eye-Related Complaints Presenting to the Emergency Department in Beirut, Lebanon, over 15 Years. J Ophthalmol 2018; 2018:4739865. [PMID: 29750120 PMCID: PMC5884157 DOI: 10.1155/2018/4739865] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/12/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To report the 15-year trend in ophthalmic presentations to the emergency department (ED) at the only medical center in Lebanon that provides 24-hour ophthalmologic care. METHODS Retrospective review of 1967 patients presenting to the ED with eye-related complaints between September 1997 and August 1998 and between September 2012 and August 2013. Diagnoses were classified into 4 categories according to the International Society of Ocular Trauma and include penetrating eye injuries, nonpenetrating eye trauma, nontraumatic ophthalmic emergencies, and nontraumatic, nonurgent ophthalmic conditions. RESULTS One thousand sixty eye-related presentations out of 39,158 total ED visits (2.71%) presented in 1997 compared to 907 out of 46,363 in 2012 (1.96%). Penetrating and nonpenetrating eye emergencies decreased between 1997 and 2012 (7.17% to 4.19%, p = 0.003 and 52.64% to 29.00%, p < 0.001, resp.) while nonurgent cases increased from 30.19% to 53.47% (p < 0.001). 57% of patients were covered by third-party guarantors in 1997 versus 73% in 2012. CONCLUSION Our results demonstrate a significant increase in nonurgent cases in parallel with the proportion of third-party payers, an issue to be addressed by public health policies and proper resource allocation. A detailed nationwide review is needed to make solid recommendations for the management of ophthalmologic presentations in the ED.
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Affiliation(s)
- Haytham I. Salti
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Carl-Joe Mehanna
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Bachir Abiad
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nicola Ghazi
- Department of Ophthalmology, Cleveland Clinic Foundation, Abu Dhabi, UAE
| | - Samih Raad
- Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Anita Barikian
- Department of Ophthalmology, University of Tennessee Health Science Center, Hamilton Eye Institute, Memphis, TN, USA
| | - Randa Haddad
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Adnan Ashkar
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Elie Harmouche
- Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Elie Zaghrini
- Department of Emergency Medicine, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon
| | - Afif Mufarrij
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Shaeri M, Moravveji A, Fazel MR, Rangraz Jeddi F. Status of ocular trauma in hospitalized patients in Kashan, 2011: As a sample of industrial city. Chin J Traumatol 2016; 19:326-329. [PMID: 28088935 PMCID: PMC5198933 DOI: 10.1016/j.cjtee.2016.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Ocular trauma is the third leading cause of hospitalization in ophthalmology patients, imposing direct and indirect physical and psychological costs on society. This study aims to investigate the status of ocular trauma in hospitalized patients in the industrialized city of Kashan in 2011. METHODS This cross-sectional descriptive applied study was conducted in 2012 on patients hospitalized for ocular trauma. Data, including age, gender, occupation, education, timing of admission following accident, location of accident, type of injury, damaging instrument, and type of trauma, were collected using a questionnaire designed by a trained nurse, and analyzed using SPSS-16 software by means of means ± standard deviation, frequency, and percentage for descriptive data and t-test, one-way analysis of variance, Chi-square and Fisher exact test for analysis at significance level of p < 0.05. RESULTS In total, 82 patients were hospitalized due to ocular traumas. The majority of patients were male (65 patients, 79.3%). Their mean age was (25.4 ± 21.4) years, with an age range of 20-40 years (30 patients, 36.6%). Hyphema was the most common injury (26 patients, 25.5%), home was the most frequent incident location (32 patients, 39%), and knife or other cutting tools were mostly responsible for injuries (18 patients, 21.9%). Patients were hospitalized for 1e6 days, and the average length of stay in hospital was 2.63 days. Frequency distribution of injuries based on whether or not ruptures differed significantly among different age groups. CONCLUSION The majority of ocular trauma occurred in young males. Knife was the principle culprit for eye injuries, followed by vehicles. To reduce such incidents, it is recommended that people be trained to avoid high-risk behaviors when using knives and to better heed driving rules and regulations.
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Affiliation(s)
- Mehdi Shaeri
- Trauma Research Centre (TRUMS), Kashan University of Medical Sciences and Health Services, Kashan, Isfahan, Iran
| | - Alireza Moravveji
- Trauma Research Centre (TRUMS), Kashan University of Medical Sciences and Health Services, Kashan, Isfahan, Iran
| | - Mohammad Reza Fazel
- Trauma Research Centre (TRUMS), Kashan University of Medical Sciences and Health Services, Kashan, Isfahan, Iran
| | - Fatemeh Rangraz Jeddi
- Health Information Management Research Center, Kashan University of Medical Sciences and Health Services, Kashan, Isfahan, Iran,Corresponding author. Fax: +98 361 55548883.
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Hoskin AK, Philip SS, Yardley AME, Mackey DA. Eye Injury Prevention for the Pediatric Population. Asia Pac J Ophthalmol (Phila) 2016; 5:202-11. [PMID: 27183290 DOI: 10.1097/apo.0000000000000193] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Each year an estimated 3.3 to 5.7 million pediatric eye injuries occur worldwide. It is widely reported that 90% of ocular injuries are preventable. Our aim was to identify legislation and policies, education, and mandatory eye protection strategies that have successfully contributed to reducing rates of children's eye injuries. A literature search was conducted using the terms "pediatric" or "children" or "adolescent" and "ocular" or "eye" and "protection" or "injury prevention." Articles were retrieved based on titles and abstracts and assessed in the context of our research question. Strategies identified aimed at reducing ocular trauma fell into 3 broad categories: legislation and policies, education, and personal eye protection. Policies including restrictions on the sale and supply of certain consumer products, mandatory vehicle seatbelts, and laminated windscreens in vehicles have assisted in reducing children's eye injuries. Educational tools aimed at children and their caregivers have been effective in changing attitudes to eye health and safety. Effective pediatric eye injury prevention systems require a multifactorial approach combining legislation, policies, standards, education, and personal eye protection to limit exposure to ocular hazards. A paucity of standardized measurement and lack of funding have limited advances in the field of children's eye injury prevention. Improved eye injury surveillance and research funding along with collaboration with health care providers are important components for strategies to prevent pediatric ocular trauma.
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Affiliation(s)
- Annette K Hoskin
- From the *Lions Eye Institute, Perth; †Centre for Ophthalmology and Visual Science, University of Western Australia, Crawley; and ‡Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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Alabbasi OM, Al-Barry M, Albasri RF, Khashim HF, Aloufi MM, Abdulaal MF, Alsaidalany DW, Alahmadi AS, Habeeb H, Aalam WA. Patterns of ophthalmic emergencies presenting to a referral hospital in Medina City, Saudi Arabia. Saudi J Ophthalmol 2016; 31:243-246. [PMID: 29234226 PMCID: PMC5717507 DOI: 10.1016/j.sjopt.2016.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 03/23/2016] [Indexed: 12/01/2022] Open
Abstract
Background Data are required on ophthalmic cases that present to the emergency eye clinics in Madinah, Saudi Arabia for proper allocation of healthcare resources. Objectives To determine the frequency and various diagnoses of patients presenting to the A&E at Ohud Hospital, Madinah, Saudi Arabia. Methods Data was collected prospectively for all patients who presented to the A&E ophthalmology clinic from June 2014 to September 2014. The data was analyzed and presented using frequency of incidence and percentages. Chi-square tests were used to evaluate the diagnoses based on age, sex and nationality. P ≤ 0.05 indicated statistical significance. Results The study sample included 868 patients. The male-to-female ratio was 1.1:1.0. The main age categories included patients ≥45 years of age (256 patients) and 251 patients between the ages of 15–30 years. Various types of Conjunctivitis was the most common diagnosis, reported in 282 patients (32.5%), and followed by dry eye syndrome in 156 (18%) patients. Nasolacrimal duct obstruction in 156 patients (18%). Eyelid infections were detected in 102 patients (12%), corneal abrasion in 102 patients (9.3%). Various eye traumas was diagnosed in 30 patients (3.5%), increased intraocular pressure (IOP) in 17 patients (2%), ruptured globe in 2 patients (0.2%) and various other non-emergency pathologies in the remaining eyes. There were no significant differences in patient’s characteristics and categories of diagnoses. Conclusion Non-emergent ophthalmic cases were the most common reason for the ophthalmology emergency room visits. It was observed that most cases could be referred to outpatient departments and potentially be managed by primary healthcare providers. This would be more cost effective and will also allow for better management of vision threatening ocular emergencies.
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Affiliation(s)
| | - Maan Al-Barry
- Department of Ophthalmology, Taibah University, Medina, Saudi Arabia
| | | | | | | | | | | | | | - Hanan Habeeb
- Internal Medicine Residency Training Program, Riyadh, Saudi Arabia
| | - Waseem A. Aalam
- Department of Ophthalmology, Taibah University, Medina, Saudi Arabia
- Corresponding author.
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Psychological and quality-of-life changes after removal of the eye in a sample of adult patients, Egypt, 2013. MIDDLE EAST CURRENT PSYCHIATRY 2014. [DOI: 10.1097/01.xme.0000449845.56119.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Vajpayee RB, Shekhar H, Sharma N, Jhanji V. Demographic and clinical profile of ocular chemical injuries in the pediatric age group. Ophthalmology 2013; 121:377-380. [PMID: 23948464 DOI: 10.1016/j.ophtha.2013.06.044] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 06/22/2013] [Accepted: 06/25/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To review the risk factors, management, and visual outcomes of pediatric chemical eye injuries in a tertiary care hospital in North India. DESIGN Retrospective hospital-based study. PARTICIPANTS Patients aged <16 years with ocular chemical burns. METHODS Case records of patients with ocular chemical injury who presented to the Dr. Rajendra Prasad Centre for Ophthalmic Sciences were reviewed over a 5-year period. MAIN OUTCOME MEASURES Demographic profile, nature of chemical injury, complications, and visual outcomes after chemical injury. RESULTS A total of 134 pediatric patients with a history of ocular chemical burns were seen between March 2006 and March 2011. The mean age of patients at the time of injury was 8.95±4.89 years (range, 1.2-15.5 years); 63.4% were male. Sixty-nine patients (51.4%) belonged to the preschool (0-5 years) age group. Bilateral chemical injuries were seen in 24 patients (17.9%). Lime ("chuna") was the most commonly involved chemical (88, 65.6%) followed by toilet cleaner (20, 14.9%). The mean time between injury and presentation was 68.3 days (range, 1-365 days). Severe (grade 3 and 4) ocular chemical injury was seen in 94 patients (70.1%). Surgical intervention was performed in 114 eyes (85%) in the form of amniotic membrane grafting (n = 78), symblepharon release (n = 56), limbal stem cell transplantation (n = 26), and lamellar keratoplasty (n = 14). The average number of surgeries conducted per patient was 2.3 (range, 1-4). Median visual acuity at final follow-up (mean, 537±354 days) was 3/60. CONCLUSIONS Chemical injuries in pediatric patients are more commonly encountered in the preschool age group and are associated with severe visual loss. Alkali injury from bursting of chuna packets was the most common mode of injury in pediatric patients in our study.
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Affiliation(s)
- Rasik B Vajpayee
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Himanshu Shekhar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Jhanji
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR
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Cao H, Li L, Zhang M. Epidemiology of patients hospitalized for ocular trauma in the Chaoshan region of China, 2001-2010. PLoS One 2012; 7:e48377. [PMID: 23118997 PMCID: PMC3485239 DOI: 10.1371/journal.pone.0048377] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 09/25/2012] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The burden and pattern of ocular trauma in China are poorly known and not well studied. We aimed at studying the epidemiological characteristics of patients hospitalized for ocular trauma at major ophthalmology departments in the largest industrial base of plastic toys in China. METHODS A retrospective study of ocular trauma cases admitted to 3 tertiary hospitals in China from 1st January 2001 to 31st December 2010 was performed. RESULTS The study included a total of 3,644 injured eyes from 3,559 patients over the 10-year period: 2,008 (55.1%) open-globe injuries, 1,580 (43.4%) closed-globe injuries, 41 (1.1%) chemical injuries, 15 (0.4%) thermal injuries and 678 (18.6%) ocular adnexal injuries. The mean age of the patients was 29.0±16.8 years with a male-to-female ratio of 5.2∶1 (P = 0.007). The most frequent types of injury were work-related injuries (1,656, 46.5%) and home-related injuries (715, 20.1%). The majority of injuries in males (56.2%) and females (36.0%) occurred in the 15-44 age group and 0-14 age group, respectively. The final visual acuity correlated with the initial visual acuity (Spearman's correlation coefficient = 0.659; P<0.001). The Ocular Trauma Score also correlated with the final visual acuity (Spearman's correlation coefficient = 0.655; P<0.001). CONCLUSIONS This analysis provides an epidemiological study of patients who were hospitalized for ocular trauma. Preventive efforts are important for both work-related and home-related eye injuries.
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Affiliation(s)
- He Cao
- Injury Prevention Research Center, Medical College of Shantou University, Shantou, Guangdong Province, People’s Republic of China
| | - Liping Li
- Injury Prevention Research Center, Medical College of Shantou University, Shantou, Guangdong Province, People’s Republic of China
| | - Mingzhi Zhang
- Joint Shantou International Eye Centre, Shantou, Guangdong Province, People’s Republic of China
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Abstract
Purpose To analyze the patterns, causes, and outcome of pediatric ocular trauma at Assiut University Hospital in Upper Egypt (South of Egypt). Methods All ocular trauma patients aged 16 years or younger admitted to the emergency unit of Ophthalmology Department of Assiut University between July 2009 and July 2010 were included in the study. The demographic data of all patients and characteristics of the injury events were determined. The initial visual acuity and final visual acuity after 3 months follow-up were recorded. Results One hundred and fifty patients were included. The majority of injuries occurred in children aged 2–7 years (50.7%). There were 106 (70.7%) boys and 44 (29.3%) girls. The highest proportion of injuries occurred in the street (54.7%) followed by the home (32.7%). Open globe injuries accounted for 67.3% of injuries, closed globe for 30.7%, and chemical injuries for 2%. The most common causes were wood, stones, missiles, and glass. LogMar best corrected visual acuity at 3 months follow-up was: 0–1 in 13.3%; <1–1.3 in 27.3%; <1.3–perception of light (PL) in 56%; and no perception of light (NPL) in 3.3%. Conclusions Pediatric ocular trauma among patients referred to our tertiary ophthalmology referral center in Upper Egypt over a period of 1 year was 3.7%. Of these, 67.3% of cases had open globe injury, 30.7% had closed injury, and only 2% had chemical injury. In Upper Egypt, socioeconomic and sociocultural status, family negligence, and lack of supervision are important factors in pediatric eye injuries, as 92% of children were without adult supervision when the ocular trauma occurred. Nearly 86.6% of children with ocular trauma end up legally blind. Modification of these environmental risk factors is needed to decrease pediatric ocular morbidity.
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