Clinical Ophthalmology (Oct 2022)
Demographic, Clinical Profile and Management Outcomes of Ocular Chemical Injuries in Saudi Children
Abstract
Huda Al-Ghadeer,1 Mohammed Al Amry,1 Khalid A Aldihan,2 Omar S Alobaidan,2 Ghadah Mohammed S AlQahtani,2 Rajiv Khandekar3 1Emergency Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 2Ophthalmology Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 3Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaCorrespondence: Huda Al-Ghadeer, Emergency Department, King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh, 11462, Saudi Arabia, Tel +966 1 4821234 ext. 2500, Email [email protected]: 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.Keywords: burns, chemical, child, cornea, eye, injuries, stem cell