Elisabeth CA Macdonald, Paul A Cauchi, Augusto Azuara-Blanco, Barny Foot

Authors have no financial interest

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Chemical injuries to the eye represent one of the true emergencies in ophthalmology

They may require extended medical care and result in longterm ocular morbidity

Public health and occupational health strategies have attempted to reduce the rate of these

The true incidence of these in the UK and subsequent demand on medical services was unknown

This study aimed to estimate the national incidence of severe chemical corneal injuries in the UK

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Prospective population based study

Performed with British Ophthalmological Surveillance Unit (BOSU) monthly reporting system Run by the RCOphth, UK

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Monthly report card with case definition sent to all consultant or associate specialist ophthalmologists with clinical autonomy in the UK

Respondents indicate how many cases they have seen that month

Investigators are notified of positive reports Reporting ophthalmologist is contacted using a

questionnaire to collect information regarding case

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12 month study period Dec 2005- Nov 2006

Report of any severe chemical corneal injury

Def.- an injury with all of the following:1. Total loss of the corneal epithelium

2. Corneal haziness obscuring iris detail or worse

3. Over 120o of limbal ischaemia Grade 3 or 4 on the Hughes-Roper-Hall scale

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Monthly card return rate 78%

Twelve cases were identified

Min. estimated incidence in the UK of severe chemical corneal injury of 0.02 per 100 000

66.7% of injuries were in males of working age (16-65yrs)

Min. estimated incidence in the UK of severe chemical corneal injury in males of working age of 0.04 per 100 000

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75% occurred in males

Mean age at time of injury was 33.8 yrs Range 10–59 yrs

50% occurred at work 33.3% resulted from assault

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Alkali was causative in 66.7%

Only one patient was wearing eye protection at the time of injury

75% received immediate irrigation

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Six patients required 1 or more surgical procedures Amniotic membrane graft was the most

common surgical procedure

At 6 months follow-up BCVA 6/12 or better in 5 patients 6/60 or worse in 2 patients

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The incidence of severe chemical corneal injury in the UK is low

The cases that occur can require extended hospital treatment, with substantial ocular morbidity and visual sequelae

Current enforcement of eye protection in the workplace in the UK has probably contributed to a reduced incidence of severe ocular burns

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