Topical Anesthetic Abuse Keratopathy: A Commonly Overlooked Health Care Problem
Küçük Resim Yok
Tarih
2011
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
LIPPINCOTT WILLIAMS & WILKINS
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Purpose: To evaluate the clinical course, treatment modality, factors affecting the epithelization period, and visual outcome in patients with topical anesthetic abuse keratopathy. Methods: The medical records of 19 patients with a confirmed diagnosis of topical anesthetic abuse keratopathy were retrospectively examined; occupation, initiating event, biomicroscopic findings, treatment modality, epithelization period, and best-corrected visual acuity (BCVA) were noted. The Wilcoxon signed rank test was used to compare BCVA before and after treatment; P values < 0.05 were considered statistically significant. Results: In all, 26 eyes in 19 men aged 21-44 (mean age: 31 +/- 6) years were included. Initiating events included exposure to arc welding flash (8 patients), metallic foreign body injury (8 patients), and chemical injury (3 patients). On admission to hospital, 10 patients (52.6%) reported that they were using topical anesthetics. Upon admission to the hospital, 10 patients (52.6%) self reported that they were using topical anesthetics. The remaining 9 subjects were discovered to be using topical anaesthetic drops during hospitalization. Twelve patients (63.2%) were found to continue using these agents during their hospitalization. Oval corneal epithelial defect, stromal infiltrate, ring-shaped keratitis, and hypopyon were noted in 100%, 46.2%, 57.7%, and 42.3% of the eyes, respectively. Topical antibiotics (fluoroquinolones or combined fortified cephalosporins and aminoglycosides), preservative-free lubricants/autologous serum, and bandage contact lens/eye patches were used for treatment. Mean epithelization period was 19.96 +/- 11.16 days (range: 6-50 days). Mean pretreatment and posttreatment BCVA was 0.12 +/- 0.16 (range: 0.001-0.7) and 0.66 +/- 0.30 (range: 0.0-1.0), respectively (P < 0.001). Conclusions: Ophthalmologists should be suspicious of topical anesthetic abuse keratopathy in young male manual laborers specialized in welding business and foundry work presenting with persistent epithelial defects, ring-shaped keratitis, and accompanying severe ocular pain.
Açıklama
Anahtar Kelimeler
topical anesthetic abuse, occupation, persistent epithelial defect, corneal ulcer, ring keratitis
Kaynak
CORNEA
WoS Q Değeri
Q2
Scopus Q Değeri
Q1
Cilt
30
Sayı
5
