title: Course and outcome of accidental sodium hydroxide ocular injury.
abstract: OBJECTIVE
  To evaluate the course and outcome of patients with accidental ocular alkali burns.
  
  
  METHODS
  Prospective, interventional case series.
  
  
  METHODS
  Study of a cohort of 16 patients (31 eyes) who sustained concomitant accidental sodium hydroxide ocular burns and received appropriate treatment at a tertiary care eye hospital in India. The patients were followed up for 1 year, and parameters including best-corrected visual acuity, epithelial defect area, conjunctival and limbal involvement, and injury-related complications were evaluated.
  
  
  RESULTS
  Severe sodium hydroxide exposure of a mean duration of 12 ± 2.5 minutes and delay in specialist eye care caused moderate to severe injury (grade II, 19% [n = 6]; grade III, 19% [n = 6]; grade IV, 10% [n = 3]; and grade VI, 52% [n = 16]). Median best-corrected visual acuity at presentation was 1.0 logarithm of the minimal angle of resolution (logMAR) units (range, 0.3 to 1.9 logMAR units), and at 1 year, it was 1.0 logMAR units (range, 0 to 1.9 logMAR units; P = .121). The median initial epithelial defect was 100 mm(2) (range, 18 to 121 mm(2)), which healed in all eyes by 3.5 months. Initial median limbal involvement was 12 clock hours (range, 3 to 12 clock hours), resulting in a residual limbal stem cell deficiency of 6 clock hours (range, 0 to 12 clock hours) at 1 year. Most common complications were glaucoma and cataract. Corneal ulcers developed in 2 eyes, and keratolimbal graft was performed in 1 patient. Grade VI injuries had significantly worse outcome than the lower-grade injuries.
  
  
  CONCLUSIONS
  The course and outcome of ocular alkali burns depends on effective first aid (including a thorough eyewash), age, initial grade of injury, response to treatment, prevention of secondary infection, and control of glaucoma. Despite appropriate treatment, these eyes responded poorly and carried a guarded visual prognosis.
authors: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. namrata.sharma@gmail.com
authors: Namrata
authors: N
authors: Sharma
authors: Digvijay
authors: D
authors: Singh
authors: Amit
authors: A
authors: Sobti
authors: Prakashchand
authors: P
authors: Agarwal
authors: Thirumurthy
authors: T
authors: Velpandian
authors: Jeewan S
authors: JS
authors: Titiyal
authors: Supriyo
authors: S
authors: Ghose
mesh_terms: D000062:Accidents, Occupational; D000293:Adolescent; D000328:Adult; D002057:Burns, Chemical / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D003229:Conjunctival Diseases / Q000139:chemically induced / Q000473:pathology / Q000628:therapy; D003315:Cornea / Q000187:drug effects*; D003316:Corneal Diseases / Q000139:chemically induced / Q000473:pathology / Q000628:therapy; D005126:Eye Burns / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012972:Sodium Hydroxide / Q000009:adverse effects*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing; D055815:Young Adult
chemical_list: D012972:Sodium Hydroxide