Ocular and systemic morbidity profile in mass formic acid injuries.
OBJECTIVE
A report on formic acid-induced ocular and systemic injuries.


METHODS
Forty-two passengers (84 eyes) with formic acid burns following a tanker and bus collision were evaluated and treated. The severity of ocular chemical injury was assessed using the Roper-Hall classification. Standard protocol for management of ocular chemical burns was adopted in all patients. Immediate irrigation of the eyes was done with tap water and all patients received frequent topical steroids, cycloplegics, and lubricating eye drops. Systemic injuries were evaluated and managed collectively by plastic and orthopedic surgeons and internists.


RESULTS
On presentation, 48 (57.14%) eyes had grade 0, 13 (15.48%) eyes had grade I, 16 (19.1%) eyes had grade II, 3 (3.57%) eyes had grade III, and 4 (4.76%) eyes had grade IV chemical injuries. Thirty patients (71.43%) had superficial and 12 (28.57%) had deep skin burns. One (2.38%) patient died due to severe pulmonary edema and 6 (14.29%) patients had severe pulmonary complications requiring oxygen treatment. Seventy-two (87.8%) eyes healed without residual sequelae, 10 (12.2%) eyes had nebulo-macular corneal opacities, and 2 (2.44 %) eyes developed secondary glaucoma and dry eye.


CONCLUSIONS
Formic acid injuries can lead to a significant ocular and systemic morbidity. Immediate ocular and systemic management is necessary to reduce morbidity and mortality. Strict regulations are needed for the transportation of dangerous chemicals to prevent accidental chemical injuries.
Ram
Jagat
J
Department of Ophthalmology, Post-Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
Sukhija
Jaspreet
J
Behera
Digamber
D
Gupta
Amod
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002057:Burns, Chemical / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005126:Eye Burns / Q000139:chemically induced* / Q000175:diagnosis; D005151:Facial Injuries / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005561:Formates / Q000009:adverse effects*; D006490:Hemostatics; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D015599:Trauma Severity Indices; D055815:Young Adult
D005561:Formates; D006490:Hemostatics; C030544:formic acid