Ocular injuries among hospitalized burn victims: A one year census at a national tertiary center
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Abstract
Ocular injuries are potentially sight-threatening complications of burns that are frequently overlooked in clinical practice. To describe the epidemiology, mechanisms, clinical spectrum, and outcomes of ocular burns in hospitalized patients. We performed a one-year retrospective census of all burn in-patients who received ophthalmology consultation at Motahari Hospital, Tehran (April 2021–March 2022). Demographics, burn characteristics, ocular findings, management, and outcomes were extracted from charts and analyzed using descriptive statistics and chi-square or Mann-Whitney U tests. Among 1,914 admissions, 74 (3.9%) received ophthalmologic consultation, and 69 (3.6%) were diagnosed with ocular injuries. Patients were predominantly male (78%) with a median age of 29 years (Interquartile Range (IQR) 6–47 years). Flame exposure was the commonest mechanism (49%), followed by chemical (19%) and scald (19%) burns. Eyelid involvement occurred in 99% of cases, conjunctiva 61%, cornea 39% and limbus 7%. Corneal injury was significantly associated with chemical burns (p = 0.01). Ninety-two percent received medical therapy alone; 14% underwent surgery (cutaneous graft 9%, ocular procedure 5%). The median length of stay was 9 days (IQR, 5–16). Permanent ocular sequelae developed in five patients (7%), and mortality was 20%. In this large tertiary cohort, ocular burns affected 1 in 25 admitted burn patients, chiefly young men injured at home. The eyelids shield deeper structures, yet chemical exposure remains a significant threat to the cornea and limbus. Early ophthalmic assessment and standardized lubrication protocols could reduce the need for reconstructive surgery. Public-health measures aimed at domestic fire safety and chemical handling are warranted. This study highlights the importance of implementing routine ocular screening protocols in burn units, particularly for patients with high-risk exposures.
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