Clinical Outcomes and Etiological Factors in Ocular Chemical and Thermal Burns

Yıl 2025, Cilt: 15 Sayı: 3, 317 - 323, 15.09.2025

Çisil Erkan Pota , Özge Ekin Geçer Şerifoğlu , Olgar Öcal , Hatice Deniz İlhan

https://doi.org/10.16919/bozoktip.1700287

Öz

Objective:
To evaluate the clinical findings of patients admitted to the emergency department due to thermal and chemical ocular burns and to investigate the etiological causes.
Materials and Methods:
The examination findings of 4,821 patients who were referred for ophthalmologic consultation to the emergency department of xxx Faculty of Medicine between 2019 and 2024 were evaluated. Among these, 474 (9.8%) were identified as cases of chemical and thermal corneal burns. Patients' age, gender, causative agents, initial examination findings, and the presence of permanent damage after treatment were assessed. Examination findings were classified according to the Roper-Hall classification.
Results:
Of the 474 patients included in the study, 82.1% were adults and 17.9% were pediatric. The male-to-female ratio was 58.4% to 41.6%, respectively. In the pediatric group, the most common cause of corneal burns was adhesives, whereas in adults, the leading cause was bleach (sodium hypochlorite, NaClO). Bleach, adhesives, and thermal agents were the most common causes of initial damage, while bleach was found to be the leading agent in causing permanent complications. Limbal ischemia due to chemical burns was observed in 14 (2.9%) patients. There was a statistically significant difference between causative agents in terms of both initial clinical findings and permanent complications (p<0.001, p<0.025). Bleach caused the highest rate of permanent damage. However, the acidic, basic, or neutral nature of the substance was not found to be significantly associated with permanent damage (p=0.245). In the pediatric group, the most common agents were adhesives and neutral substances, while in adults, bleach and acidic substances were predominant (p<0.001). No limbal ischemia was observed in the pediatric group, and there was no significant difference in complication rates between the two age groups (p=0.597). In terms of gender distribution, women were more frequently exposed to cleaning agents, while men were more commonly exposed to agricultural chemicals, adhesives, and acids (p<0.001). However, no significant difference was found between genders regarding corneal involvement or complications (p=0.790, p=0.408). Permanent vision loss and ocular surface damage were observed in 5 (1.05%) patients. Secondary to limbal ischemia and other ocular surface issues, we observed complications such as corneal neovascularization, leukoma, symblepharon, corneal stromal scarring, and trichiasis.
Conclusion:
In conclusion, chemical and thermal corneal burns are serious ophthalmic emergencies. It should be noted that alkali burns lead to more severe outcomes and that early treatment is associated with better prognosis. We believe early intervention and appropriate treatment are critical in promoting healing of the ocular surface and preventing permanent vision loss.

Anahtar Kelimeler

ocular chemical burn , thermal corneal burn , corneal burn , limbal ischemia , leukoma , symblepharon

Etik Beyan

This study was approved by the local ethics committee (Approval Number TBAEK - 376) where the study was conducted, by the ethical standards of the Declaration of Helsinki.

Oküler Kimyasal ve Termal Yanıklarda Klinik Sonuçlar ve Etiyolojik Faktörler

Öz

Amaç: Acil servise termal ve kimyasal oküler yanık nedeniyle başvuran hastaların muayene bulgularının değerlendirilmesi ve etiyolojik nedenlerin araştırılması
Gereç ve Yöntem: 2019-2024 yılları arasında xxx Tıp Fakültesi acil servisine göz konsültasyonu ile başvuran 4821 hastanın muayene bulguları değerlendirildi.Bu hastalardan 474 (9.8%) kimyasal ve termal oküler yanık olgusu olduğu gözlendi. Hastaların yaş, cinsiyet, maruz kaldıkları etken maddeler, ilk muayene bulguları ve tedavi sonrası kalıcı hasar durumu ve değerlendirildi. Hastaların muayene bulguları Roper-Hall sınıflamasına göre sınıflandırıldı.
Bulgular: Çalışmaya dahil edilen 474 hastadan %82.1'i yetişkin, %17.9'u pediatrik yaş grubundadır. Erkek hasta oranı %58.4, kadın hasta oranı ise %41.6’dır. Pediatrik grupta en sık yapıştırıcı, yetişkin grupta ise çamaşır suyu (sodyum hipoklorit) nedeniyle korneal yanık gözlenmiştir İlk muayenedeki hasar açısından çamaşır suyu, yapıştırıcı ve termal hasarın en sık bulguya yol açtığı, kalıcı hasar açısından ise en sık komplikasyona çamaşır suyunun sebep olduğu gözlendi. Limbal iskemi, kimyasal yanıklara bağlı olarak 14 (2.9%) hastada gözlemlenmiştir. Etken maddeler arasında hem ilk muayene bulguları hem de kalıcı komplikasyonlar açısından anlamlı fark bulunmuştur (p<0.001, p<0.025). En fazla kalıcı hasara çamaşır suyu yol açmıştır. Ancak maddenin asidik, bazik veya nötr olmasının kalıcı hasar açısından etkili olmadığı saptanmıştır (p=0.245). Pediatrik grupta en sık etken yapıştırıcı ve nötr maddelerken, yetişkinlerde çamaşır suyu ve asidik maddeler ön plandadır (p<0.001). Pediatrik grupta limbal iskemi saptanmamış, iki grup arasında komplikasyon oranı açısından fark bulunmamıştır (p=0.597). Cinsiyet dağılımında kadınlar temizlik maddelerine, erkekler tarım ilaçları, yapıştırıcı ve asitlere daha fazla maruz kalmıştır (p<0.001). Ancak korneal tutulum ve komplikasyon açısından cinsiyetler arasında anlamlı fark saptanmamıştır (p=0.790, p=0.408).. Hastaların 5’inde (1.05%)’inde görme kaybı ve oküler yüzeyi etkileyen kalıcı hasar gözlenmiştir.Hastalarda limbal iskemi ve diğer oküler yüzey problemlerine sekonder olarak korneal vaskülarizasyon , lökom, semblefaron, korneal stromal skar ve trikiazis olabileceğini gözlemledik.
Sonuç: Sonuç olarak, kimyasal ve termal korneal yanıklar ciddi oftalmik acil durumlardır. Alkali yanıkların daha ciddi sonuçlar doğurduğu ve erken tedavi ile daha iyi prognozlar elde edilebileceği unutulmamalıdır. Erken müdahale ve doğru tedavi, oküler yüzeyin iyileşmesini sağlamak ve kalıcı görme kaybını engellemek için kritik öneme sahip olduğunu düşünüyoruz

Anahtar Kelimeler

oküler kimyasal yanık , termal korneal yanık , korneal yanık , limbal iskemi , lökom , semblefaron

Etik Beyan

This study was approved by the local ethics committee (Approval Number TBAEK - 376) where the study was conducted, by the ethical standards of the Declaration of Helsinki.

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