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Severe ocular chemical injury in the UK: a British Ophthalmological Surveillance Unit study

Eye (2024)Cite this article

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Abstract

Background

Severe ocular chemical injury is a potentially devastating condition which most commonly affects men of working age. Workplace injuries previously accounted for the majority of incidents, but there has been a recent increase in assaults involving corrosive substances throughout the UK. The objectives of this study were to determine the incidence and demographics of severe ocular chemical injury and describe current surgical management practices.

Methods

Cases were prospectively ascertained through the British Ophthalmological Surveillance Unit monthly reporting system during 2019–21. In total, 20 cases involving 29 eyes met the inclusion criteria.

Results

The reported incidence of severe ocular chemical injury during the pre-pandemic period of the study was 0.24 per million. Cases due to alleged assault have become more common than workplace injuries. A total of 81% patients had persistent complications at 6 months requiring ongoing treatment, and 60% patients required surgical intervention.

Conclusion

Although there are limitations with the case ascertainment methods, severe ocular chemical injury remains rare within the UK. There has been a proportionate increase in cases related to alleged assault compared with previous similar studies. Amniotic membrane grafting remains the most commonly performed surgical procedure in these patients.

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Fig. 1: Initial examination findings.
Fig. 2: Complications at 6 months.
Fig. 3: Surgical intervention initially and at 6 months.

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Data availability

The datasets generated and analysed during the current study are available from the corresponding author upon reasonable request.

References

  1. Macdonald ECA, Cauchi PA, Azuara-Blanco A, Foot B. Surveillance of severe chemical corneal injuries in the UK. Br J Ophthalmol. 2009;93:1177–80.

    Article  CAS  PubMed  Google Scholar 

  2. Metropolitan Police. Corrosive attack offenses, victims and people proceeded against 01/10/2010–30/09/2020. 2020.

  3. Hoffman JJ, Casswell EJ, Shortt AJ. Assault-related severe ocular chemical injury at a London ophthalmic referral hospital: a 3-year retrospective observational study. BMJ Open. 2020;10:e038109.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Figueiredo FC, Bruce C, Cartes C, Pradhan S. Rising incidence of ocular chemical injury secondary to assault in the Northeast of England. Investig Ophthalmol Vis Sci. 2021;62:1318.

    Google Scholar 

  5. Corbett MC, Bizrah M. Chemical injuries of the ocular surface. College News. 2018.

  6. Kuckelkorn R, Keller GK, Redbrake C. Emergency treatment of chemical and thermal eye burns. Acta Ophthalmol Scand. 2002;80:4–10.

    Article  PubMed  Google Scholar 

  7. Roper-Hall MJ. Thermal and chemical burns. Trans Ophthalmol Soc UK. 1965;85:631–53.

    CAS  PubMed  Google Scholar 

  8. Dua HS, King AJ, Joseph A. A new classification of ocular surface burns. Br J Ophthalmol. 2001;85:1379–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Foot B, Stanford M, Rahi J, Thompson J. The British Ophthalmological Surveillance Unit: an evaluation of the first 3 years. Eye. 2003;17:9–15.

    Article  CAS  PubMed  Google Scholar 

  10. Office for National Statistics (ONS), released 21 December 2022, ONS website, statistical bulletin, Population estimates for the UK, England, Wales, Scotland and Northern Ireland: mid-2021. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/mid2021.

  11. Ling R, Cole M, James C, Kamalarajah S, Foot B, Shaw S. Suprachoroidal haemorrhage complicating cataract surgery in the UK: epidemiology, clinical features, management, and outcomes. Br J Ophthalmol. 2004;88:478–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Kamalararjah S, Silvestri G, Sharma N, Khan A, Foot B, Ling R, et al. Surveillance of endophthalmitis following cataract surgery in the UK. Eye. 2004;18:580–7.

    Article  Google Scholar 

  13. Morgan S. Chemical burns of the eye: causes and management. Br J Ophthalmol. 1987;71:854–57.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Kuckelkorn R, Luft I, Kottek AA. Chemical and thermal eye burns in the residential area of RWTH Aachen. Analysis of accidents in 1 year using a new automated documentation of findings. Klin Monatsbl Augenheilkd. 1993;203:397–402.

    Article  CAS  PubMed  Google Scholar 

  15. Acid Survivors Trust International. A worldwide problem. 2021. https://www.asti.org.uk/a-worldwide-problem.html.

  16. Mahmood S, von Lany H, Cole MD, Charles SJ, James CR, Foot B, et al. Displacement of nuclear fragments into the vitreous complicating phacoemulsification surgery in the UK: incidence and risk factors. Br J Ophthalmol. 2008;92:488–92.

    Article  CAS  PubMed  Google Scholar 

  17. Institute for Government. Timeline of UK government coronavirus lockdowns and restrictions. 2022. https://www.instituteforgovernment.org.uk/data-visualisation/timeline-coronavirus-lockdowns.

  18. Office for National Statistics (ONS), released 8 December 2022, ONS website, statistical bulletin, Travel to work, England and Wales: Census 2021. https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/bulletins/traveltoworkenglandandwales/census2021.

  19. McKinlay AR, Fancourt D, Burton A. A qualitative study about the mental health and wellbeing of older adults in the UK during the COVID-19 pandemic. BMC Geriatr. 2021;21:439.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Ridsdale L. Covid-19: “protecting the NHS” encourages people with symptoms to stay at home. BMJ. 2020;370:m3515.

    Article  PubMed  Google Scholar 

  21. Green MA, McKee M, Hamilton OKI, Shaw RJ, Macleod J, Boyd A, et al. Associations between self-reported healthcare disruption due to covid-19 and avoidable hospital admission: evidence from seven linked longitudinal studies for England. BMJ. 2023;382:e075133.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank all the ophthalmologists who reported cases for this study and express their gratitude to the British Ophthalmological Surveillance Unit for their support.

Funding

This study has been undertaken with funding from Buckinghamshire Healthcare NHS Trust. The British Ophthalmological Surveillance Unit is supported by Fight for Sight.

Author information

Authors and Affiliations

  1. Ophthalmology Department, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK

    Nicola Cronbach

  2. Royal College of Ophthalmologists, London, UK

    Barny Foot

  3. Ophthalmology and Oculoplastic Department, Chelsea & Westminster Hospital, London, UK

    Richard Scawn

Authors
  1. Nicola Cronbach
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  2. Barny Foot
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  3. Richard Scawn
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Contributions

NC, BF, RS: conceived and/or designed the work that led to the submission, acquired data, and/or played an important role in interpreting the results, drafted or revised the manuscript, approved the final version, agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Nicola Cronbach.

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Cronbach, N., Foot, B. & Scawn, R. Severe ocular chemical injury in the UK: a British Ophthalmological Surveillance Unit study. Eye (2024). https://doi.org/10.1038/s41433-024-03073-6

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