Hand sanitizer associated ocular chemical injury: A mini-review on its rise under COVID-19

Ocular Trauma During COVID-19 Pandemic: A Systematic Review and Meta-analysis

PURPOSE

This study aimed to summarize the latest literature on the trends and incidence of ocular trauma during the COVID-19 pandemic.

DESIGN

Systematic review and meta-analysis.

METHODS

A systematic literature search was conducted to identify the relevant literature. The search period was between January 1, 2020, and September 20, 2021. The incidence of overall and various types of ocular trauma during the COVID-19 pandemic and the control period was analyzed. The data from different studies were pooled. The odds ratio (OR) and 95% confidence interval (CI) were calculated.

RESULTS

A total of 32 articles were included. After pooling the data from all included studies, the incidence of total and pediatric ocular trauma during the COVID-19 pandemic was 67.7% and 54.3% of those in the control period, respectively. However, the proportion of ocular trauma in eye emergency visits increased during the pandemic (OR, 95% CI: 1.46, 1.04-2.06). The proportion of domestic ocular trauma increased (OR, 95% CI: 3.42, 1.01-11.62), while ocular trauma related to sports and outdoor activities and occupational ocular trauma decreased (OR, 95% CI: 0.64, 0.09-4.29 and 0.18, 0.10-0.33, respectively). It was also reported that chemical injury caused by alcohol-based sanitizers, photokeratitis caused by ultraviolet lamps, and mechanical eye injury caused by masks increased during the COVID-19 pandemic.

CONCLUSIONS

There was a reduction in overall eye injuries and substantial differences in the spectrum of ocular trauma during the COVID-19 pandemic. Proper health education and supervision should be strengthened to prevent ocular injuries related to COVID-19 preventive interventions.

COVID-19 Changed Prevalence, Disease Spectrum and Management Strategies of Ocular Trauma

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the health of people around the world and has reshaped social behaviors and clinical practice. The purpose of this perspective is to provide epidemiologists and clinicians with information about how the spectrum of ocular trauma diseases changed, as well as to optimize management for improving patient prognosis during this crisis. Analysis of current studies revealed that the prevalence of eye trauma decreased overall, with a trend of delayed medical treatment during the COVID-19 era. Irregular epidemic prevention and control measures, unprotected home activities, and unusual mental states are the main causes of ocular trauma. Strategies for reducing morbidity are also discussed, including popularizing the use norms of prevention and control supplies, taking heed to the safety of family activities, highlighting the special status of child protection, and paying attention to previous case data to implement region-specific precautions. The procedure of ophthalmological emergency and outpatient management should also be optimized, and mental health should be emphasized during this pandemic.

Shifting trends in demographic features of chemical eye injuries during COVID-19 pandemic

Objectives

To evaluate the etiological cause distribution in chemical eye injuries during COVID-19 pandemic.

Methods

In this retrospective case series, the medical records of patients, who presented with chemical eye injuries between March 30, 2020, and March 1, 2021, were evaluated and compared with the data covering 10 years before the pandemic.

Results

Twenty-seven eyes of twenty-three patients (19 adults, 4 children) who presented in pandemic period were included. Alcohol-based hand sanitizer was one of the two most common agents (n = 6 eyes) in the pandemic era. In the last 10 years before the pandemic, 137 eyes of 102 patients were treated for chemical eye injuries. Injuries due to alcohol-based hand sanitizer increased from 3.1 to 21.1% among all patients, and from 0 to 75% among pediatric patients during the pandemic era compared to the pre-pandemic period. The increase was statistically significant both in all patients (p = .003) and in the pediatric patient group (p = .048).

Conclusion

Due to COVID-19 pandemic, alcohol-based hand sanitizer use became more common. Consequently, the frequency of hand sanitizer related chemical injuries showed a 13-fold increase and the age group affected by such accidents is altered during the pandemic. Three out of four pediatric patients (75%) were injured with alcohol-based hand sanitizers, which draws attention to the fact that improperly placed hand sanitizer stations, being just at the eye level of children, can cause chemical eye injuries in the pediatric population even more.

Alcohol-Based Hand Sanitizers in COVID-19 Prevention: A Multidimensional Perspective

The global use of alcohol-based hand sanitizers (ABHS) as an important means of controlling the transmission of infectious disease has increased significantly as governments and public health agencies across the world advocated hand hygiene as a preventative measure during the COVID-19 pandemic. Although the performance of these products is most commonly defined as a function of their alcohol concentration, they are multifaceted products in which an interplay of several factors is important in determining efficacy. This paper discusses the interplay between ABHS input (formulation) factors and output (product performance) factors in the context of a multidimensional perspective using a novel representative paradigm. In the model, represented in the form of a three-dimensional tetrahedron, each of the faces represents inputs in the manufacturing of the ABHS product, which are the type and amount of alcohol, the inactive ingredients, the formulation and the manufacturing practices. The four corners of the tetrahedron represent the product performance factors which include product efficacy, sensory characteristics, usage and compliance and product safety. The multidimensional approach to the formulation and evaluation of ABHS shows that several factors contribute to the effectiveness and utility of these products. The paradigm provides a useful framework for manufacturers of ABHS and related healthcare products.

The impact of COVID-19 pandemic on ophthalmic referrals within a tertiary academic center in Oman

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