title: Clinical Practice Guidelines for Prevention, Diagnosis and Management of Early and Delayed-onset Ocular Injuries Due to Mustard Gas Exposure.
abstract: OBJECTIVE
  To develop clinical practice guidelines (CPGs) for prevention, diagnosis, treatment and follow-up of ocular injuries caused by exposure to mustard gas.
  
  
  METHODS
  The clinical questions were designed by the guideline team. Websites and databases including National Guidelines Clearinghouse, National Institute for Clinical Excellence, Cochrane, and PubMed were searched to find related CPGs and explore possible answers to the clinical questions. Since there were no relevant CPGs in the literature, related articles in Persian and English languages were extracted. Each article along with its level of evidence was summarized. Additionally, hand search was performed by looking the reference list of each article. Consequently, recommendations were developed considering the clinical benefits and side effects of each therapeutic modality. The recommendations were re-evaluated in terms of customization criteria. All recommendations along with the related evidence were scored from 1 to 9 by experts from all medical universities of Iran. The level of agreement among the experts was evaluated by analyzing the given scores.
  
  
  RESULTS
  The agreement was achieved for all recommendations. The experts suggested a number of minor modifications which were applied to the recommendations. Finally, CPGs were developed with 98 recommendations under three major domains including prevention of injury, diagnosis and management of the acute and delayed-onset mustard gas ocular injuries.
  
  
  CONCLUSIONS
  Considering the lack of CPGs for the prevention, diagnosis, and management of mustard gas-induced keratitis, these recommendations would be useful to prevent the serious ocular complications of mustard gas and standardize eye care services to the affected individuals.
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Zhale
authors.initials: Z
authors.lastname: Rajavi
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sare
authors.initials: S
authors.lastname: Safi
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Javadi
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Jafarinasab
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sepehr
authors.initials: S
authors.lastname: Feizi
authors.affiliation: Janbazan Medical and Engineering Research Center, Tehran, Iran.
authors.forename: Mohammadreza Sedighi
authors.initials: MS
authors.lastname: Moghadam
authors.affiliation: Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Khosrow
authors.initials: K
authors.lastname: Jadidi
authors.affiliation: Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Babaei
authors.affiliation: Standardization and CPG Development Office, Deputy of Curative Affairs, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Armin
authors.initials: A
authors.lastname: Shirvani
authors.affiliation: Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Baradaran-Rafii
authors.affiliation: Department of Ophthalmology, Torfeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Mohammad-Rabei
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Ziaei
authors.affiliation: Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ghassemi-Broumand
authors.affiliation: Department of Ophthalmology, Torfeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Siamak Delfaza
authors.initials: SD
authors.lastname: Baher
authors.affiliation: Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Naderi
authors.affiliation: Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Mahmoodreza
authors.initials: M
authors.lastname: Panahi-Bazaz
authors.affiliation: Department of Ophthalmology, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Siamak
authors.initials: S
authors.lastname: Zarei-Ghanavati
authors.affiliation: Department Research and Development, Parsian Clinic of Ophthalmology, Isfahan, Iran.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Hanjani
authors.affiliation: Department of Ophthalmology, Shahed University, Tehran, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Ghasemi
authors.affiliation: Department of Ophthalmology, Shiraz University of Medical Sciences, Tehran, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Salouti
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mojgan
authors.initials: M
authors.lastname: Pakbin
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Kheiri
keywords: Clinical Practice Guidelines; Eye Injury; Iran; Mustard Gas