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Sahu SK, Radhakrishnan RV, Mohanty CR, Parija S, Palanisamy S, Mishra P, Sadangi D. Pattern and clinical profile of patients with ocular trauma presenting to the emergency department of a teaching hospital in India: A prospective observational study. Turk J Emerg Med 2024; 24:90-96. [PMID: 38766413 PMCID: PMC11100578 DOI: 10.4103/tjem.tjem_219_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/25/2024] [Accepted: 02/01/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVES One major contributor to avoidable ocular morbidity is ocular trauma (OT). The study aimed to document the epidemiological factors, pattern of injury, and outcome among patients with OT presenting to the emergency department (ED). METHODS This was a prospective observational study conducted in the ED of a tertiary care teaching hospital in Eastern India after due approval from the institutional ethics committee. The data were collected during the period from March 2021 to February 2022. Data pertaining to age, sex, type of injury, mechanism of injury, time and place of injury, details of tissue involvement, visual acuity, any prior history of injury, initial diagnosis, and management were noted. To estimate the severity of the injury and the probable visual outcome, we calculated through OT score (OTS), including one raw score and OTS. Statistical analysis was performed using the R, version 4.6.1. RESULTS A total of 180 patient's data were included for final analysis. The median (interquartile range) age of the patients was 32 (24-45) years. The majority were males (n = 147 [81.6%]) with a male-female ratio of 4.5:1. Road traffic accidents (RTA) were the common cause of injury (n = 122 [67.7%]). Unilateral eye involvement was the most common (n = 147 [81.6%]). In the pattern of injury, most of the patients sustained closed globe injuries (CGIs) (n = 158 [87.7%]). Among the CGIs, injury to the ocular adnexa and conjunctiva (n = 141 and 127, respectively) was the most common. Injury to the retina and choroids occurred in 20 (11%) patients. The vision was not affected in most of the cases (n = 125 [69.4%]) with a visual acuity of > 6/18. The majority (n = 120 [67%]) of the patients had an OTS of grade-4, followed by grade-2 (n = 22 [12%]). Most of the patients required only medical management (n = 100 [56%]), whereas 77 (43%) patients required surgical interventions. CONCLUSION OT was a common presentation in the ED. Male patients with monocular injuries involved in RTAs were mostly affected. The vision was preserved in most of the cases.
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Affiliation(s)
- Sandip Kumar Sahu
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | | | - Chitta Ranjan Mohanty
- Department of Trauma and Emergency, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sucheta Parija
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | | | - Priyadarshini Mishra
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Debasish Sadangi
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Choudhry HS, Zhu A, Shaikh S, Zaki H, Masket S, Law SK. Epidemiology of Consumer-Product-Related Ocular Injuries in the Geriatric Population in the United States. Ophthalmol Ther 2024; 13:367-384. [PMID: 37995015 PMCID: PMC10776527 DOI: 10.1007/s40123-023-00852-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/02/2023] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION The purpose of this study was to assess trends in consumer-product-related geriatric ocular injuries using National Electronic Injury Surveillance System (NEISS) data. Understanding the specific consumer products and settings coded in the NEISS dictionary that contribute to geriatric (≥ 65 years) ocular injuries, along with changing patterns during events like the COVID-19 pandemic, provides crucial insights for tailoring therapy and preventative strategies. This ultimately may reduce the burden of eye injuries on both older adults and healthcare systems. METHODS This was a retrospective population-based cohort study. The NEISS database was used to study eye injuries in geriatric adults from 2010 to 2021. Patients were categorized by age groups (65-74, 75-84, 85-94, ≥ 95 years), and data on demographics, injury types, product categories, and COVID-19 impact were collected. Pearson's chi-squared test (with p < 0.001 taken to indicate significance) was used to assess differences in expected ratios between age groups. RESULTS A total of 168,685 eye injury cases in adults aged 65 years and older were analyzed. Household items, tools, and gardening products accounted for over 75% of injuries. Most injuries occurred at home (65.3%). Contusions/abrasions (40.3%) and a foreign body (19.3%) were common diagnoses. Females had more household-item-related injuries, while males had more foreign body injuries. Regarding therapeutic disposition, 93.7% of all injuries were treated/examined and released, which showed a decreasing trend as age increased, while hospital admission/transfer rates increased with age. Compared to before COVID-19, the percentage of injuries during COVID-19 due to tools decreased (from 22.5% to 18.3%), while injuries due to gardening/lawn/landscaping/patio products increased (from 13.8% to 15.3%). CONCLUSIONS Our study characterizes geriatric ocular injuries and COVID-19 impact, highlighting common products and locations. Different age groups showed different injury patterns. Understanding these trends can aid injury prevention strategies for consumers and healthcare providers. Demographics and injury frequencies differed based on age and sex. Future research should further explore post-COVID-19 trends.
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Affiliation(s)
- Hassaam S Choudhry
- Medical Science Building, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA.
| | - Aretha Zhu
- Medical Science Building, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA
| | - Sadiq Shaikh
- Medical Science Building, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA
| | - Haider Zaki
- Medical Science Building, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA
| | | | - Simon K Law
- UCLA Stein Eye Institute, 100 Stein Plaza, Los Angeles, CA, 90095, USA
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Sumual V, Lukandy A, Sutanto RL. Closed-globe injury due to metallic foreign body in an elderly worker: A case report. Int J Surg Case Rep 2023; 110:108694. [PMID: 37611401 PMCID: PMC10466905 DOI: 10.1016/j.ijscr.2023.108694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/12/2023] [Accepted: 08/12/2023] [Indexed: 08/25/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Cases of ocular trauma in developing countries are often found with more severe conditions due to increased socioeconomic burden, inadequate safety measures, lack of optimal treatment facilities, and poor education. Here we present a case on an elderly worker in a developing country, showing the importance of prompt treatment albeit in a resource-limited setting. CASE PRESENTATION A 61-year-old male metalworker presented with closed globe injury after metal debris impact during his work shift 3 h ago. Physical examination showed left eye visual acuity of 1/60, conjunctival injection, corneal blood and fibrovascular tissue, a small foreign body, relative afferent papillary defect, and lens opacities. Ultrasound confirmed vitreous cavity abnormalities. Surgical removal of a foreign body and scleral suturing were performed after an 8-hour delay due to limited staff during night shift. Postoperative follow-up indicated improved vision acuity to 3/60. While the overall prognosis was favorable, the patient did not attend subsequent outpatient follow-up appointments, possibly due to financial barriers, raising concerns regarding long-term management. CLINICAL DISCUSSION Ocular trauma remains a significant contributor to visual impairment and avoidable blindness, carrying potential long-term implications for quality of life. This case presentation serves as a poignant reminder of the socioeconomic repercussions of ocular injuries, particularly among workers in resource-constrained environments of the developing world. CONCLUSION The notable delays in timely surgical intervention, coupled with financial limitations underline the multifaceted nature of barriers faced.
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Affiliation(s)
- Vera Sumual
- Department of Ophthalmology, Prof. R. D. Kandou General Hospital, Jl. Raya Tanawangko No. 56, Manado, Indonesia; Department of Ophthalmology, Faculty of Medicine, Sam Ratulangi University, Jl. Kampus Unsrat, Manado, Indonesia.
| | - Andry Lukandy
- Department of Ophthalmology, Faculty of Medicine, Sam Ratulangi University, Jl. Kampus Unsrat, Manado, Indonesia
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Muacevic A, Adler JR, Banerjee M, Ghosh S, Mitra AN, Chakraborty M, Sengupta M. Microbiological Profile in Patients Having Keratitis in a Tertiary Care Hospital in India. Cureus 2022; 14:e31653. [PMID: 36545169 PMCID: PMC9760353 DOI: 10.7759/cureus.31653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 11/21/2022] Open
Abstract
Background Corneal ulcer or keratitis is defined as a loss of corneal epithelium with underlying stromal infiltration and suppuration associated with signs of inflammation. Corneal blindness is a significant public health problem worldwide; infectious keratitis is one of the predominant preventable causes of blindness. Several studies have evaluated microbial infectious keratitis's etiology, management, and outcome. However, there are regional variations in corneal ulcers' prevalence, risk factors, and outcome. The objective of this study was to isolate and identify the bacterial, fungal, viral, and protozoal etiological organisms causing infectious corneal ulcers along with their prevalence and antimicrobial sensitivity pattern. Methods A prospective observational study was done in the Department of Microbiology and RIO, Medical College & Hospital, Kolkata, for a period of 1 year (February 2019 to January 2020) after obtaining clearance from the Institutional Ethics Committee. Informed consent, demographic data, history of disease onset, duration of symptoms, associated co-morbidities, etc., were taken from the patients fulfilling the inclusion criteria. Corneal scraping samples were collected sterilely to detect bacterial, fungal, parasitic, and viral isolates and identified by standard laboratory procedures. Results A total of 80 patients were included in the study. The risk factors included foreign body in 24 (30%), blunt trauma in 10 (12.5%), steroid use in 8 (10%), contact lens user 4 (5%), and spontaneous in 34 (42.5%). Among these 80 patients, 18 showed growth of bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, and Pseudomonas aeruginosa; four had growth of fungi, including Aspergillus spp. and Fusarium spp, and two were positive for Herpes simplex virus by IFA. Conclusion Early diagnosis and prompt keratitis treatment are critical for preventing visual loss. The identification of the various causative agents of keratitis is essential for the proper management of the cases.
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Epidemiology and trends of ocular trauma hospitalizations in Chile from 2001 to 2020. J Fr Ophtalmol 2022; 45:1055-1062. [DOI: 10.1016/j.jfo.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/27/2022] [Accepted: 03/17/2022] [Indexed: 11/22/2022]
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Kousiouris P, Klavdianou O, Douglas KAA, Gouliopoulos N, Chatzistefanou K, Kantzanou M, Dimtsas GS, Moschos MM. Role of Socioeconomic Status (SES) in Globe Injuries: A Review. Clin Ophthalmol 2022; 16:25-31. [PMID: 35027817 PMCID: PMC8749045 DOI: 10.2147/opth.s317017] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Abstract
Globe injury is a serious worldwide public health issue frequently leading to permanent vision impairment. The plethora of different types of globe injuries is classified into categories, including open and closed globe injuries. Globe injury occurs mainly in the workplace and at home, affecting predominantly middle-aged working men. Socioeconomic status (SES) is defined by income level, educational attainment, and employment status. Low socioeconomic status has been associated with a higher incidence of globe injury and can be utilized to identify at-risk populations. For managing open and closed globe injuries, different strategies are applied and the implementation of adequate globe injury prevention measures is needed for reducing the occurrence of globe injury. The following article aims to provide an overview of globe injury characteristics and their correlation with socioeconomic status and to highlight the significance of considering SES as a variable in globe injury prevention.
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Affiliation(s)
- Panagiotis Kousiouris
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Olga Klavdianou
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Konstantinos A A Douglas
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Nikolaos Gouliopoulos
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, "Attikon" General Hospital, Athens, Greece
| | - Klio Chatzistefanou
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Maria Kantzanou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios S Dimtsas
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Marilita M Moschos
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
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Description of Main Predictors for Taking Sick Leave Associated with Work-Related Eye Injuries in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105157. [PMID: 34067993 PMCID: PMC8152250 DOI: 10.3390/ijerph18105157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022]
Abstract
Recent studies in Spain have shown that males, younger workers, and people involved in manual jobs had the highest risk of suffering a work-related eye injury (WREI). This study aims to assess the predictors of sick leave associated with WREI and to compare them with risk factors of initial injury. A retrospective and descriptive study of WREI that causes sick leave of one or more days among workers from an insurance labor mutual company in Spain was conducted over a period from 2008 to 2018. The variables of the study were sex, age, occupation, and type of injury. A total of 9352 (18.6% of 50,265 WREI) cases and 113,395 total days of sick leave were observed, with an estimated EUR 4,994,009.59 of associated labor cost. The main predictors of sick leave related to WREI were found to be female (highest incidence; 25.9 (95% CI (24.8–27.1))), >55 years of age (highest incidence; 20.5 (95% CI (19.3–21.7))), not working in the industry (lowest incidence; 13.8 (95% CI (13.3–14.2))), and not suffering “other disorders of conjunctiva” (lowest incidence; 5.7 (95% CI (4.7–6.8))). The consequences associated with WREI are worse for female and older workers, despite the main risk of suffering WREI being observed in males and younger workers.
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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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