ORIGINAL
CHEMICAL EYE INJURIES
© 2012 by Acta Medica Saliniana
ISSN 0350-364X
¹Mirjana A. Janicijevic-Petrovic,
¹Tatjana S. Sarenac-Vulovic,
²Katarina M. Janicijevic,
²Dragan I. Vujic,
²Dejan D. Vulovic
DOI: 311/14
Institution
¹Clinic of Ophthalmology, Clinical
Centre in Kragujevac, Serbia
²Faculty of Medical Sciences,
University in Kragujevac, Serbia
Received:
30.01.2013
Accepted:
12.05.2013
Corresponding author
Mirjana A. Janičijević-Petrović
Kneza Miloša 3/1-1, 34000 Kragujevac,
Serbia
mob: 066013691
e-mail:mira.andreja@yahoo.com
Competing interests
The authors declare no
competing interests.
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Mirjana A. JANIĆIJEVIĆ-PETROVIĆ, 1Tatjana S. ŠARENAC-VULOVIĆ,
1
2
Katarina M. JANIČIJEVIĆ, 2Dragan I. VUJIĆ, 2Dejan D. VULOVIĆ
Introduction: Chemical eye injuries are described as urgent trauma of eye and localized
mostly on anterior segment. Cause of injuries is acid, alkali, mixed and non identified
agents. Diagnostic procedure is easy, but therapy is complex.
Aim: The aim of study was to describe the epidemiology and cause of the most common
agents involved in serious chemical eye injuries at our tertiary referent region.
Material/methods: A retropective study (3 years) of serious chemical eye injuries
(Grade II/III) presenting at Clinic of ophthalmology in Clinical Centre in Kragujevac, Ser-
bia. One-hundred and thirteen patients (164 eyes) presented between January, 2010 and
December, 2012 for observation with chemical eye injuries. Authors showed important
characteristics: sex, age, categories of chemical agents and location where injury occurred.
Results: Males were more often observed than females (66.37% vs. 33.63%). The mean
age across all categories was 46-60 years (54; 47.79%). The most common categories of
chemical agents: hydrochloric acid - 42 (25.61% - eyes), acetic acid – 37 (22.56% - eyes),
quicklime – 37 (22.56% - eyes), quenched – 24 (14.63% - eyes), spray-mix – 24 (14.63% -
eyes). The location where injury occurred: home – 84 (51.22% - eyes), work – 80 (48.78%
- eyes).
Conclusion: Correlation and our world references, a medium urban countries, with dom-
inators and medium industries is more easily developed relative identical, except that in
our frequency allocated by serious chemical injury males professionally in social and pri-
vate industry sector, as these are dominated by female in households, while maintaining
general hygiene.
Keywords: epidemiology, chemical eye injuries, categories of agent
INTRODUCTION in Clinical Centre in Kragujeva of Serbia.
One-hundred and thirteen patients (164
Chemical eye injuries fall into urgent oph-
eyes) presented in our eye department
thalmologic pathology and localized usual-
(tertiary, referent region) between January,
ly on anterior segment with complications
2010 and December, 2012 for observation
and residual sequels as nubeculo-macular
and treatment with serious chemical eye
corneal opacities, secondary glaucoma, dry
injuries. We showed the most important
eye, etc. Cause of these injures are acids,
characteristics: sex, age, the most common
bases, mixed and unidentified substances.
categories of chemical agents (nature of
The chemical eye injuries occur in setting
chemical agent) and location - place where
of accidents at workplace or in home, at ag-
injury occurred. The statistical analysis was
riculture, in traffic, during sports activities
done with SPSS program, version 19.00.
or during a physical attack. Chemical burns
by strong acids or bases are responsible for
the most serious injuries and blindness.
Chemical eye injuries sustained serious RESULTS
injury to the eyes, head and neck area, so
that required medical therapy and surgical Males were more often observed than fe-
intervention [7]. males 75:38 (66.37% vs. 33.63%), to 2:1. of
all patients (113) with statistical significant
(χ²=12.115, p=0.001), tab. 1.
The most frequent age group across all
MATERIAL/METHODS
categories was 46-60 years (47.79%)
A retropective study (by 3 years) of only with statistical significant (χ²=37.690,
serious chemical eye injuries (Grade II/III) p=0.000), tab. 1. The most common catego-
presenting at the Clinic of Ophthalmology ries of chemical agents were hydrochloric
27
 ACTA MEDICA SALINIANA Volume 42, No 1 : 2013 Janičijević-Petrović et al

acid - 42 (25.61% - eyes), acetic acid – 37 (22.56% - tries, foods, shopping, and for that reason with us and
eyes), quicklime – 37 (22.56% - eyes), quenched – 24 is dominated by chemical injury, more common in men,
(14.63% - eyes) and spray-mix – 24 (14.63% - eyes) but the ratio of 2:1 compared to women.
of all eyes (164), which is not statistically significant
Commonly substances are distinguished: acid in house-
(χ²=3.947, p=0.413).
hold (personal hygiene), bases in whitewashing of
Ten cases (unilateral) were observed as non identified homes and buildings, from the car battery mix-acid,
chemical agents (6.1% - of all eyes), that we did not in- and spray-mixed or as non identified chemical agents.
clude in our statistical investigation.
The most common categories of chemical agents were
The location where injury occurred (occupation) was cleaning and whitewashing agents, personal care prod-
at home place – 84 (51.22% - eyes) and at work place– ucts and automotive chemicals. Place of the injury is
80 (48.78% - eyes), which is not statistically significant home (private professional services, sports activities,
(χ²=0.221, p=0.638). hobbies) and jobs (car industry “Fiat” and social sec-
tors of the prepare foods, as bread, milk, meat, cooks,
Monocular serious chemical injuries dominated in rela-
etc).
tion to bilateral to our patients, as about 1.5:1.
The continuous increase in chemical injuries reasoning
Analysis of chemical injuries by year of observation
suggests that development of additional light, chemi-
points to the continuing growth of the same, which
cal, manufacturing our reference areas, as well as the
was in 2010 there were 27 patients (40 eyes), in 2011
fast pace of work and life, and with an increased risk
- 41 patients, (59 eyes) and in 2012 - 45 patients (65
factor – stress.
eyes).
The most common causes of injury were work-relat-
People in middle age are more likely to violate com-
ed (49.0%) and chance events (42.0%). The most fre-
pared to younger and older adults. Middle-aged men
quent ocular injury was globe injury (95.6%), including
are more frequently injured than the middle-aged
mechanical (77.6% closed and 5.9% open), chemical
women (χ²=4.299, p=0.231) which is not statistically
(7.6%), photic (2.3%) and thermal (2.2%) injuries [1].
significant, that in our study, both violate both sexes
middle age. Ocular or thermal burns account for 7.7% - 18% of oc-
ular trauma [2]. In order to decrease the incidence of
Correlation between gender and the nature of chemi-
burns, prevention, particularly in industry, is essential
cal agents (χ²=1.407, p=0.843) indicates no statistical
[2].
significance, and most chemical agents not show dom-
inance by gender. The prevalence of severe ocular chemical injury in
Shanghai is low. Successful management provides good
Correlation of sex and place of injury is statistically sig-
prognosis for most patient and the complications were
nificant (χ²=1.407, p=0.843) which indicates that men
found in 222 eyes (92.9%) [3].
are more frequently injured on the job, in government
or private sector, and women in the exercise of the Information was collected via medical record review
house. and chemical agents were classified into logical cate-
gories based on the patient-reported intended use of
Correlation of age with the nature of chemical agents
product. Demographic measures, work-related status
(χ²=5.044, p=0.956) which was not statistically signifi-
were described overall and by chemical agent category
cant, showing that they do not stand dominant chemi-
[4].
cal agent population by age, among the subjects of this
study. Various ocular alkali burn classification schemes have
been published and used to grade human chemical eye
Correlation of age with place injury (χ²=12.139,
injuries for purpose of identifying treatments and fore-
p=0.007) which was statistically significant, showing
casting outcomes. Information will have clinical appli-
that population of younger and older age groups more
cation, as well as use in development and validation of
frequently injured on the job, and older adults more of-
new methods to assess ocular toxicity [5].
ten when performing tasks at home.
Out of the 269 cases, 49% occurred in the workplace,
Correlation common nature chemical agents, perma-
28% at home. Men were involved about twice as fre-
nent injury (χ²=1.921, p=0.750) which was not statis-
quently as women, most of them at work. The majority
tically significant, showing that there is no dominant,
of women were injured at home. Alkalis were the most
chemical agents in relation to the place of injury in our
frequent chemical, implicated in 48 % cases, while
study.
strong acid caused 20% of injuries [6].
All victims sustained a burn injury to the head and neck
area and 47% of victims’ eyes were burnt. A total of
84% required surgical intervention [7].
DISCUSSION
Unexpected number chemical injury in age over 60
The estimated prevalence rate in the Central region of
years, with men or women, probably in handling with
Serbia (Kragujevac) of severe ocular chemical injury
personal hygiene or cosmetics, as well as for example
was 1.68 per 100,000. Our region is no domain of heavy
cologne water, easy for drier, remedies, glue and the
industry, but is dominated by lighter, chemical indus-

28 http://saliniana.com.ba
Janičijević-Petrović et al
like. Violations with spray with mixed chemical sub-
stances is expected in younger people.
Correlation and our world references, a medium urban
countries, as we do, with dominators and medium in-
dustries is more easily developed relative identical, ex-
cept that in our frequency allocated by chemical injury
males professionally in the private sector, as these are
dominated by the female in households, while main-
taining general hygiene. Frequently acid was hydro-
chloric acid (hygiene homes), acetic acid - canning and
food preparation, mixture of battery acid in the auto-
motive works, etc.
Frequently bases were quenched and quicklime (white-
washing walls).
Unidentified substances were related mainly to inten-
tional chemical injuries with various agents in relation
the human condition.
CONCLUSION
Correlation and our world references, a medium urban
countries, as we do, with dominators and medium in-
dustries is more easily developed relative identical, ex-
cept that in our frequency allocated by chemical injury
males professionally in social and private sector, during
sports activities, in traffic, as these are dominated by
female in households, while maintaining general hy-
giene, et agriculture, at cooks, etc.
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ACTA MEDICA SALINIANA Volume 42, No 1 : 2013
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