CLINICAL PROFILE OF CORNEAL INJURIES AND THEIR VISUAL OUTCOMES AT 12 WEEKS: AN OBSERVATIONAL STUDY FROM A TERTIARY CARE HOSPITAL IN TAMIL NADU
Abstract
Background: Corneal injuries are an important and largely preventable cause of ocular morbidity, ranging from superficial epithelial abrasions and foreign bodies to full-thickness lacerations. Visual prognosis depends on the mechanism, depth and location of injury and on the interval before treatment. Methods: An observational analytical hospital-based study was conducted in the cornea clinic of a tertiary care hospital. One hundred and thirty-three consecutive patients with a primary corneal injury were enrolled. Patients with pre-existing corneal opacity, ocular trauma without corneal involvement, previous corneal surgery, posterior segment involvement, corneal degeneration or dystrophy were excluded. History, visual acuity, slit-lamp examination and fluorescein staining were recorded at presentation, and patients were reviewed on days 1 and 3 and at weeks 1, 4, 8 and 12. Visual status was graded by World Health Organization categories. Associations with visual outcome at 12 weeks were tested by the Pearson chi-square test in SPSS version 23.0. Results: Mean age was 41 years (range 3-91) and 85 patients (63.9%) were men; 115 (86.5%) presented within 24 hours. Manual workers formed the largest occupational group (61; 45.9%), and industrial exposure was the commonest source of injury (46; 34.6%), followed by domestic injury (39; 29.3%). External corneal foreign body was the commonest mechanism (58; 43.6%), followed by blunt (32; 24.1%), penetrating (23; 17.3%) and chemical injury (20; 15.0%), of which 15 (75.0%) were alkali. Injury was confined to the epithelium in 74 patients (55.6%) and was full thickness in 25 (18.8%); the central cornea was involved in 71 (53.4%). Treatment was medical in 110 patients (82.7%) and surgical in 23 (17.3%). Normal vision rose from 52
patients (39.1%) on day 1 to 106 (79.7%) at 12 weeks, while blindness fell from 16 (12.0%) to 4 (3.0%). Outcome at 12 weeks was significantly associated with time to presentation (χ² = 47.784, p < 0.001), mechanism (χ² = 17.966, p = 0.006), depth of involvement (χ² = 40.518, p < 0.001), central corneal involvement (χ² = 7.096, p = 0.029) and final corneal clarity (χ² = 74.560, p < 0.001). Conclusion: Corneal injuries in this cohort occurred predominantly in working-age men through occupational and domestic exposure. Early presentation, superficial involvement, sparing of the visual axis and preservation of corneal clarity were each associated with better visual recovery. Workplace eye protection, public awareness and prompt ophthalmic assessment offer the clearest opportunities to reduce preventable visual loss.
Keywords
Corneal injury Ocular trauma Corneal foreign body Chemical eye burn VIsual outcome Occupational eye injuryDownload
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