నైరూప్య

Early versus delayed emergency department presentation and visual outcomes after ocular caustic chemical exposure.

Alec Chaleff, Brittany Perzia, Wei Hou, Timothy Chou

Purpose: To identify if an incident to emergency department (ED) presentation time is associated with final visual outcomes in patients with chemical ocular exposures. Methods: A retrospective chart review was performed at our Level I trauma center on all patients who presented to our ED with a chemical eye injury between May 2013 and March 2020. Ocular examination findings, patient characteristics, time from incident to presentation, and ocular surface irrigation information were recorded and analyzed for all patients who met inclusion criteria. Results: A total of 24 patients (35 eyes) met the inclusion criteria. 20 patients (83%) had alkaline chemical exposure, 3 (20%) had acidic exposure, and 1 patient (4%) was exposed to an unidentified chemical. 23 of the 24 patients (96%) self-irrigated prior to presentation for an unspecified duration. 13 patients (54%) presented by 60 minutes and 11 patients (46%) presented greater than 60 minutes after the ocular chemical exposure. The difference between the final measured visual outcome and the time to ED presentation in eyes with 20/30 or better vision at presentation and 20/40 or worse vision at presentation was not statistically significant in either group (p>0.5). There was also no statistically significant difference among an additional five clinical ocular factors and time to ED presentation between these two groups (p>0.5). Conclusion: Our findings suggest that clinicians should emphasize thorough and rapid initiation of ocular surface irrigation at the site of injury rather than rapid presentation to the ED for this purpose.