Relationship between the use and type of eye protection and work-related corneal and conjunctival foreign body injuries

Efficiency of different imaging methods in detecting ocular foreign bodies

BACKGROUND

Ocular foreign bodies (OFBs) are a relatively common occurrence in ocular injuries, and a severe risk factor for vision disorders. They are notoriously challenging to identify and localize precisely to allow surgical removal, even with the most recent technological advancements.

PURPOSE

To compare the efficiency of different imaging methods in detecting and localizing OFBs.

METHODS

We conducted a retrospective analysis of the medical records of patients with OFBs, detected by ultrasound biomicroscopy (UBM) and confirmed during surgery. Patients who presented to our medical center between January 2016 and January 2022 and also underwent computed tomography (CT), X ray, and/or ocular B-scan ultrasonography (B-scans) were selected.

RESULTS

This study included 134 patients with a history of ocular trauma and OFBs (mean age: 47.25 years, range: 8-78). The mean time interval from injury to UBM examination was 36.31 months (range: 0.2-120 months). Most OFBs were metallic (51.82%) or plant-based (25.37%); 22.39% of them were located in the sclera, 26.87% in the anterior chamber, and 23.88% in the ciliary body and iris. OFBs ranged in size from 0.10 to 6.67 mm (mean: 1.15 ± 1.10 mm). B-scans identified OFBs in 37 of the 119 patients examined (31.09%); CT in 52 of 84 patients (61.90%); and radiography in 29 of 50 patients (58.00%). Univariate and multivariate analyses determined that both CT and radiography showed low detection rates for plant-based versus non-plant-based OFBs (CT: p < 0.001; radiography: p = 0.007), small particles (<1.00 mm vs. >1.00 mm; CT: p = 0.001, radiography: p = 0.024), and with eyeball wall locations (vs. intraocular; CT: p < 0.001, radiography: p = 0.021). Similarly, B-scans were less efficient for plant-based and eyeball wall-located OFBs (both p = 0.001), whereas the difference based on dimensions was not significant (p = 0.118).

CONCLUSIONS

CT, radiography, and B-scans showed lower detection rates for plant-based, small, and eyeball wall-located OFBs. Our findings strongly suggest that UBM could be a more adequate imaging modality when such OFBs are suspected.

Corneal foreign bodies: are antiseptics and antibiotics equally effective?

PURPOSE

To compare the effect of antiseptics and antibiotics on the occurrence of Infectious Keratitis (IK) secondary to Corneal Foreign Body (CFB) removal.

METHODS

Multicenter retrospective study conducted between June 2020 and June 2022 in patients referred for CFBs and treated with Picloxydine (Group 1) or Tobramycin (Group 2) for 7 days. A follow-up visit was scheduled on Day 3 (D3) and a phone call on D30. The primary outcome measure was the occurrence of IK.

RESULTS

307 patients (300 men) with a mean age of 42.8 (14.8) years were included. The mean (SD) time to consultation was 43.1 (45.6) hours. Picloxydine and Tobramycin were given to 155 and 152 patients. Half of patients (n = 154, 50.2%) were building workers and 209 (68.1%) did not wear eye protections. CFBs were mainly metallic (n = 292, 95.1%). Upon referral, rust was found in 220 patients (72.1%). A burr was used in 119 (38.9%) patients. IK occurred in 15 (4.9%) patients, 8 (5.3%) in Group 1 and 7 (4.5%) in Group 2 (p = 0.797). IK was successfully treated in all cases. Persistent rust was found in 113 patients (36.9%) on D3 without difference between burr or needle use (p = 0.278). On D3, corneal healing was delayed in 154 patients (47.2%), mainly in burr-treated patients (p = 0.003). The mean (SD) work stoppage duration was 0.32 (0.98) days.

CONCLUSION

IK rate was 4.9%. The efficacy of antibiotics and antiseptics was similar on CFB removal. Using a burr was associated with a longer healing time. CFBs had a limited social impact.

Toxic External Exposure Leading to Ocular Surface Injury

The surface of the eye is directly exposed to the external environment, protected only by a thin tear film, and may therefore be damaged by contact with ambient particulate matter, liquids, aerosols, or vapors. In the workplace or home, the eye is subject to accidental or incidental exposure to cleaning products and pesticides. Organic matter may enter the eye and cause infection. Ocular surface damage can trigger a range of symptoms such as itch, discharge, hyperemia, photophobia, blurred vision, and foreign body sensation. Toxin exposure can be assessed clinically in multiple ways, including via measurement of tear production, slit-lamp examination, corneal staining, and conjunctival staining. At the cellular level, environmental toxins can cause oxidative damage, apoptosis of corneal and conjunctival cells, cell senescence, and impaired motility. Outcomes range from transient and reversible with complete healing to severe and sight-compromising structural changes. Classically, evaluation of tolerance and safety was carried out using live animal testing; however, new in vitro and computer-based, in silico modes are superseding the gold standard Draize test. This review examines how environmental features such as pollutants, temperature, and seasonality affect the ocular surface. Chemical burns to the eye are considered, and approaches to protect the ocular surface are detailed.

A Syringe in an Emergency Saves Time: An Audit on the Utility of Syringe Provision in Eye Emergency

Background Patient satisfaction is the top priority of health care facilities in addition to the quality of health care delivery services. The convenience of health care receivers, be it temporal or monetary, fall in this domain. Hospitals should be equipped with dealing with all kinds of emergencies no matter how trivial or catastrophic. Aim To improve the provision of emergency care equipment (1 c.c. syringes) in the examination room of our ophthalmology department by 50% in two months' time. Materials and methods This quality improvement project (QIP) was conducted in the ophthalmology department of a teaching hospital in Khyber Pakhtunkhwa. This QIP was conducted over a period of two months in the form of three cycles. All cooperative patients with embedded and superficial corneal foreign bodies who presented to the eye emergency were included in the project. The provision of 1 c.c. syringes in the emergency eye care trolley of the eye examination room was ensured at all times after the first cycle survey. A record was maintained of the percentage of patients receiving syringes from the department as well as the percentage of patients purchasing them from the pharmacy. The progress was measured every 20 days, following the approval of this QI project. Results A total of 49 patients were included in this QIP. This QIP shows that the provision of syringes was improved to 92.8% and 88.2% in cycles 2 and 3 from the previous statistics of 16.6% in the first cycle. Conclusions It is concluded that this QIP achieved its target. The provision of emergency equipment, such as a 1 cc syringe costing less than 1/20th of a dollar, is a simple act that saves resources and improves patient satisfaction.

Trends in Workplace-Related Eye Injuries in the United States From 2011 Through 2020

Purpose

To provide insight into the current scope of workplace-related eye injuries (WREIs) by describing the demographic profiles and causes of WREIs from the years 2011 through 2020.

Methods

The US Bureau of Labor Statistics (BLS) dataset on WREIs injuries was used. Descriptive data generated included the frequency of eye injuries, the setting, and demographic data.

Results

The BLS reported an estimated 237 590 WREIs in the study timeframe. In that time, the incidence fell from 2.4 to 1.7 per 10 000 workers. These injuries commonly occurred in men (77.1%), White individuals (36.3%), those aged 25 to 34 years (26.9%), and those in the service (23.0%) and production (18.5%) industries. On average, WREIs resulted in a median of 2 missed workdays, with only 5.0% missing more than 1 month of work. Between 2019 and 2020, there was a 15.6% reduction in total WREIs in the US but a 39.3% increase in WREIs among healthcare workers.

Conclusions

Men, White individuals, and younger workers might be at increased risk for WREIs. Public health interventions targeted toward improving access to and the quality of protective equipment in these groups and in fields involved in the primary or secondary sectors of industry and healthcare might be the most cost-effective measure to reduce the impact of WREIs on the US workforce.

Prevalence of ocular findings regardless of visual acuity status in older adults from the Brazilian Amazon Region

Recently, it has been recommended that population-based studies report not only frequencies of vision impairment and blindness but also any ocular abnormalities that might lead an individual to seek for eyecare services. The current study aimed to determine prevalence of ocular findings regardless of visual acuity (VA) status in older adults from the Brazilian Amazon Region. Disturbances were grouped into: Eyelids; Anterior Segment; Posterior Segment; Increased intraocular pressure; and Overall Globe. The presence of an ocular finding was considered positive when any abnormality was noted, regardless of VA. Refractive errors were not considered. A total 2384 eligible persons were enumerated and 2041 (85.6%) examined. The prevalence of ocular disturbances in either eye was 87.0% and was associated with male gender, older age, lower education, and rural residence. Overall, main findings were pterygium, cataract, and pinguecula, occurring in 58.8%, 45.4% and 17.4%, respectively. Among individuals with 20/20 VA in both eyes, the most frequent findings were pterygium, pinguecula, and glaucoma cupping, occurring in 47.4%, 31.2% and 6.5%, respectively. The high prevalence of ocular findings observed in this population reinforces that different conditions might not immediately decrease VA but can indicate risk and/or discomfort symptoms and should be considered when planning public health ophthalmic services.