Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Archana Dambal

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Dr. Archana Dambal
Department of General Medicine,
Belgaum Institute of Medical Sciences,Belgaum, Karnataka,INDIA,
On 30 Nov 2018




Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
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Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




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Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
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I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




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Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
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Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2011 | Month : October | Volume : 5 | Issue : 5 | Page : 1076 - 1081

A Study on Industrial Eye Injuries

Somashekar P. Biradar, Arvind H.S.

Corresponding Author. Consultant Ophthalmologist, Bangalore, India.

Correspondence Address :
Somashekar.P.Biradar
Asst. Prof, Dept. of Ophthalmology
SN Medical College, Navanagar,
Bagalkot.587102, Karnataka.
Ph; 09945090687
Email addres: drsomubiradar@yahoo.co.in

Abstract

Background: Eye injuries have been known since ancient times. Although nature has provided a protective bony wall and lids to cover the eye to protect it from injury, it is still exposed to all types of trauma. Trauma is the leading cause of patient presentation to the eye clinic, accounting for 52% of the patient load. Occupational eye injuries are more common in younger men and comprise 70% of all the ocular injuries.

Aim of the Study: To determine the various aetiological factors which are responsible for ocular injuries in various industrial environments and to assess the types of injuries and their outcomes in various types of occupations.

Material and Methods: This study included 65 cases with a history of trauma, which was sustained while working, who presented directly or were referred to the Aravind Eye Hospital, Coimbatore, during the study period from May 2003 to December2004. In all the cases, a thorough history was obtained, with particular emphasis on the type of industry, the nature of work, the hours of work daily, the exact nature of the event which led to the injury and the object which caused the injury. The patient’s symptoms following the injury were enquired about in detail. A relevant past ocular and general medical history was obtained for risk assessment in the present ocular injury. The history of prior treatment for the injury was recorded. All the patients were subjected to a complete ophthalmic examination. Their visual outcomes were considered.

Results: The males were commonly injured. The commonest age group which was affected was the 21-30 years age group. Mechanical injuries were the most common type of injury.

Conclusion: An attempt was made to find out the various aetiological factors for ocular injuries and their visual outcomes.

Keywords

Eye Injury, Industry, Visual outcome

How to cite this article :

Somashekar P. Biradar, Arvind H.S.. A STUDY ON INDUSTRIAL EYE INJURIES. Journal of Clinical and Diagnostic Research [serial online] 2011 October [cited: 2019 Aug 26 ]; 5:1076-1081. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2011&month=October&volume=5&issue=5&page=1076-1081&id=1558

Introduction
The incidence of ocular injuries is constantly on the rise. It is difficult to accurately measure or even estimate the incidence of eye injuries. Worldwide, there are approximately 1.6 million people who have become blind, 2.3 million who have become bilaterally visually impaired and 19 million with unilateral visual loss due to eye injuries. Trauma is the commonest cause of unilateral blindness today. From the international perspective, an estimated 5,00,000 blinding eye injuries occur annually worldwide (1).

In an Indian survey, injuries were found to be the cause of blindness in 11.8% of the total blind subjects (A pilot survey from Jaipur, Rajasthan). The lifetime prevalence of ocular injuries in the USA is estimated at over 1400/100,000 population. The annual rate of eye injuries is 13.2/1000 population (2).

The importance of injuries has been highlighted by studies on occupational injuries. The toll of the industrial ocular injuries extendsbeyond the pain and visual limitation of the injured. The direct cost of medical and surgical treatment and hospitalization and the indirect cost of the loss of productive work hours are shared by the society. In USA, the direct and indirect costs of all the injuries combined together have been estimated at 75 to100 million dollars (3).

Occupational eye injuries are more common in younger men and comprise 70% of all the ocular injuries. Males have a 2.2 to 5.5 times higher risk of sustaining eye injuries than females (4), (5).

Automotive industry workers had the highest incidence of open globe injuries (6).

In most of the cases of ocular injuries, it is the anterior segment of the eye including the conjunctiva, the cornea, the iris, the lens and the angle of the anterior chamber, which bears the burden of the direct and indirect force of the injuries. Blunt injuries account for 49.7% of all the ocular injuries (4), (5).

The ultimate goal is to prevent secondary complications and to maximize the patients’ visual prognosis, so as to enable the patients to carry on their normal activities and occupations.

Material and Methods

This was a prospective study which was conducted during the period from May 2003 to December 2004. A total of 65 cases were included, with a history of trauma which was sustained while working, who presented directly or were referred to Aravind Eye Hospital, Coimbatore. The age group of the patients ranged from 18-58 years. Ethical clearance was obtained for this study from the ethical committee. Consent was obtained from all the subjects who were involved in this study.

In all the cases, a thorough history was obtained, with particular emphasis on the type of industry, the nature of work, the hours of work daily, the exact nature of the event which led to the injury and the object which caused the injury. Any eye afflictions and a history of poor vision in the eyes, previous eye check-ups and the use of power glasses, protective glasses, shields, helmets and face protectors was asked. Any associated systemic diseases and alcohol and any drug intake at the time of the injury was noted. The activity at the time of the injury was classified as follows: hammering metals or stones, handling machinery for drilling, welding, grinding or polishing, handling chemicals or molten metals, working on power looms or others. A proforma was drawn up and the details were recorded for each patient. A relevant past ocular and general medical history was obtained for risk assessment in the present ocular injury. The history of prior treatment for the injury was recorded.

The patients’ symptoms following the injury like pain, watering, photophobia, diminished vision, loss of vision, floaters, redness, bleeding, etc., were enquired about in detail.

All the patients were subjected to a complete ophthalmic examination, which included: visual acuity assessment by using the standard Snellens chart in literates and the ‘E’ chart in illiterates, slit-lamp biomicroscopy and fundus examination by using direct and indirect ophthalmoscopy. Tonometry with applanation, tonopen or a noncontact tonometer, gonioscopy with a 4-mirror lens and refraction by using tropicamide and phenylephrine were done to assess the posterior segment in appropriate cases. All the ocular findings were recorded by using diagrams wherever necessary and the important fundus findings were also documented by colour photography by using a fundus camera and slit lamp photography.

Results

A survey on 65 cases (71 eyes), with a history of injury which was sustained at work in various industries, who presented to the Aravind eye Hospital, Coimbatore, directly or by referrals, was conducted during the study period and the clinical data which was collected, analyzed and compiled. Comparison of the categorical variables was done by using the Pearson’s Chi Square test for association. A “p” value which was less than 0.05 was considered to be significant.

The injured were aged 30.5+/–9.8 years and were as young as 18 years, the oldest being 58 years.

Most of the injuries were in the age group of 21-30 years. There was only one (1.5%) female in the study sample.

The object of the injury was flying particles in 66.7% of the cases. Splashing of dangerous chemicals was the cause of injury in 23.1% of the cases.

Mechanical injuries were the most common type of injury in a large proportion of patients as compared to the non-mechanical injuries.

The injuries which occurred due to machines or mechanical forces formed the major proportion (62%); followed by 50.7% due to open globe, 11.3% due to closed globe 31% due to chemicals and 7% due to thermal causes.

Overall, 16.9% of the eyes presented with rupture and 33.8% with perforating injuries and 11.3% required foreign body removal. Almost one third (32.3%) of the injuries were thermal or chemical in nature.

Discussion

Age and Sex Distribution of the Sample (Table/Fig 1)
A majority of the injuries were found in the 21 to 30 years age group. Probably the cases were under training in their respective areas and hence were more exposed to the injuries due to ignorance or inexperience. There appeared to be a very less proportion of women who reported with an injury. This could be due to reasons such as (1) less number of women in the industries, (2) women being employed in less dangerous departments or (3) women being very careful in their work and adhering to the safety measures. This finding was similar to that of other studies by Lambah, Malik and Shukla, who reported that a high number of males were affected as compared to the females varying from 80-90% (7), (8), (9).

A majority (75.4%) of the cases were from the Coimbatore district itself, followed by 13.8% from the Erode district and 4 cases from the neighbouring state of Kerala. The number of injuries indicated that the magnitude could be very high, as Coimbatore was an industrial city and there were only few numbers of tertiary eye care centers. Hence, the number of affected cases (though not a prevalence rate) can be an under estimate of the real situation.

Occupationwise Distribution of the Sample
Occupation (Table/Fig 2): Machine tool operators or mechanics constituted a major (32.3%) part of the patients in the study. Labourers from various industries reported 23.1% of the injuries. 9.2% of the quarry workers were injured. Chemical handlers also were prone (7.7%) to the eye injuries.

Other studies; Shukla, Koval, Dannenberg and Malik reported (29.2%), (28.2%), (22%), and (19.7%) of the cases as those with occupational injuries (10),(11),(12),(13).

Activity during the injury (Table/Fig 3): A majority (38.5%) of the injuries occurred when the subject was hammering, followed by the handling of chemicals or acids (23%). The injury occurred while handling hot metals in 5(7.7%) cases. Three persons (4.6%) were bystanders when the injury occurred. Patients who were workingin other industries apart from the chemical industry were also exposed to chemicals at work. For example, chemicals such as bleach, caustic soda and other acids are used in the textile industry during the processing of yarn and during the dyeing and finishing of the garments. Similarly, various chemicals are used in the tools and during the stages of cleaning, treatment and polishing.

Industrywise distribution of the sample (Table/Fig 4): The place of work at which the injuries occurred was mostly workshops (53.8%), followed by textile mills where nearly one fifth (18.5%) of the injuries were caused and foundries where 10.8% of the injuries were caused. The chemical factory was the place of injury in 4.6% of the cases. All the cases reported that there was adequate illumination in their work place. However, 4 (6.2%) cases said that there was not enough ventilation.

Object of the injury (Table/Fig 5): The object of the injury was flying particles in 67.7% of the cases. The splashing of dangerous chemicals was the cause of injury in 23.1% of the cases.

This was similar to reports by others. Roper-Hall reported 30.4% injuries which were caused due to hammering (13). Rubsamen reported that chisels and hammers were responsible for 49% of the injuries (14). Malik reported that the use of hammers was the cause in 46.3% of the eye injuries (8).

Jain reported the incidence of flame burns to be 1.3% (15). Shukla and Verma reported chemical injuries to constitute 3% of the total injuries (16), as also Jain who reported 3% chemical eye injuries (15).

Time taken for the presentation: The presentation to the clinic was early in a majority of the cases. This shows that eye injuries are real ophthalmic emergencies which demand prompt and early attention. The presentation to the hospital is influenced by the type and severity of the injury.

Experience: Only 8 (12.3%) cases were new to the industry/ department, with an experience of less than one year. A majority (50.8%) of the cases who presented with eye injuries had an experience of more than five years. Injuries can occur at any point of time, irrespective of the experience in the field. Probably the workers with less experience were still trainees in the field. There could have been neglect and lethargy in using protection in the latter group.

Awareness and the usage of protective gear: Forty-four (67.7%) cases were not aware that there was a possibility of eye injuries. The rest (21 cases) who were aware of the possibility of an injury, knew that they had to use protective gear at their workplace.

The provision of protective gears for the eyes was not available in a major proportion (76.9%) of the cases. Of the 15 cases that had the provision, 9 (13.85%) wore it ‘regularly’ and 6 (9.2%) wore it ‘occasionally’.

Most (87.7%) of the cases were not wearing protective gear at the time of the injury. Eight persons (12.3%) had an injury in spite of wearing protection at the time of the injury.

Previous ocular eye examination: Only 9 (13.8%) cases had their eyes examined prior to the injury. The reason for the eye examination was glass penetration in 5 (55.6%) cases and a routine check up in 4 cases. One patient was one-eyed. Presbyopia was the predominant (12.3%) problem which was reported before the injury. Uncorrected refractive error was reported by 3 (4.6%) cases. There was one squint eyed and one hyperopic case in the study sample.

Laterality: Six (9.2%) cases had injuries in both eyes as a result of chemical splashing. Among the unilateral injuries, the eye which was involved was the right eye in a majority (60%) of the cases and the left eye in 20 (30.8%) cases.

This indicates that chemical injuries were the most common cause of the bilateral eye injuries.

Type of injury (Table/Fig 6): Mechanical injuries are broadly classified as open globe and closed globe injuries. Open globe injuries (Table/Fig 7) include IOFB (Intraocular Foreign Body), rupture, penetrating, and perforating injuries. Closed globe injuries include contusion, lamellar laceration and superficial foreign body (17).

The injuries which were caused by machines or mechanical forces formed the major proportion (62%) of the injuries – 50.7% were open globe and 11.3% were closed globe injuries, followed by those which were caused by chemicals (31%) and thermal causes (7%).

Mechanical injuries: A majority of the cases had an injury in the structures in the anterior segment, while the posterior segment injuries were less. This was similar to the findings of other authors who have reported a higher incidence in the anterior segment of the eye than in the posterior segment.

Thermal and Chemical injuries: There were thermal injuries (Table/Fig 8) in 5 eyes and chemical injuries (acid or alkali burns) in 22 eyes .Chemical injuries were the most common (6 cases) causes of the bilateral eye injuries.

Jain reported the incidence of flame burns to be 1.3% (15). Shukla and Verma reported chemical injuries to comprise 3% of the total injuries (16), as also Jain who reported 3% chemical eye injuries.

Structurewise involvement of the eye in the injury (Table/Fig 9): The highest involvement was of the anterior segment structures. The cornea was the most commonly involved site, followed by the conjunctiva and the eyelids. In the cornea, the most commonly involved site was the tear film. Conjunctival burns and lid burns were common. Shallowing of the anterior chamber and hyphema (Table/Fig 10) were common changes following the injury. Iris prolapse was the most common change. Cataract was the most common lens change following the trauma. Retinal oedema and tear were the common posterior segment changes.

Malik reported that the highest incidence of injuries was in the cornea (55.8%), followed by the iris (44.1%) and the eyelids (33.2%)(8). Shukla and Verma reported the involvement of the conjunctiva in 92.5%, the cornea in 64% and the eyelids in 21.75% of the cases (16). Koval reported that the cornea was involved in 81.2% of the cases (11). Mukherjee also reported the cornea as the mostcommon site of perforation in 62.21%, as the corneoscleral in 29.26% and as the sclera in 8.5% of the cases (18).

Approximately 66% of the penetrating wounds were caused through the cornea, 10% were caused through the sclera and the remainder were caused through the limbus.

Most of the authors reported uveal prolapse and lenticular damage as the common sequelae following the perforation.

The presenting visual acuity (VA ): The grading of the visual acuity is done as follows (17): Grade I >20/40 Grade II 20/50 to 20/100 Grade III 20/100 to5/200 Grade IV 4/200 to PL (Perception of Light) Grade V No PL All injuries were graded for subjective visual acuity. There was no eye that presented with no light perception (Grade V). Most (38%) of the eyes presented with a visual acuity of 4/60-PL. One third (32.4%) of the eyes presented with a visual acuity of 6/12 or better.

Association of presenting Visual Acuity with predisposing factors: The presenting visual acuity of the injuries was associated with the type of injury, the experience of the work, the time of presentation and with the wearing of protective gear. There was no statistically significant association between the experience, the time of presentation and the wearing of the gear and the visual acuity at presentation.

However, the nature of the injury did influence the presenting visual acuity. The p value was less than 0.001 and so there was a significant association between the type of injury and the presenting visual acuity. Three fourth (75%) of the eyes that had closed injuries had a visual acuity of 6/36 or better as compared to 22.2% eyes among the open injuries. The open globe injuries mostly (61.1%) presented with a visual acuity of 4/60-PL.

Conclusion

Potential eye hazards are found in nearly every industry. Males were more commonly injured than the females. The commonest age group which was affected was the 21-30 years age group. The higher incidence among the youth causes visual disability and has a tremendous burden on the financial and social perspectives and on the quality of life of the individuals.

The number of injuries indicated that the magnitude could be very high, as Coimbatore was an industrial city and there were only few numbers of tertiary eye care centers. Hence, the number (though not a prevalence rate) could be an under estimate of the real situation.

Mechanical injuries were the most common type of injury and comprised a large proportion of the cases. Chemical injuries are the most common cause of bilateral eye injuries that cause serious functional disability and hence, special efforts should be made to prevent them. Thermal injuries were seen in foundry and steel industry workers, which were caused by molten metal.

Acids, alkalies, bleach and dyes are not only used in chemical industries, but are also used in textile manufacturing and processing.

Chemical splashing was the commonest mode of injury. Most of the chemical injuries were of grade I, but the severe injuries causedocular surface problems and needed prolonged rehabilitation measures with surface reconstructive procedures.

The commonest cause of thermal burns was the falling of hot metal. Eyelid and conjunctival burns were the most common lesions. If the burns were localized and deeper, they often necessitated procedures like AMG to avoid symblepharon and scarring.

Mechanical injuries were frequently found to occur in the workshops of various industries. Workers who were engaged in activities like hammering were the most frequently affected ones. Even persons in the supervisory cadre can get eye injuries. Machine operators were more prone to eye injuries.

Mechanical injuries are often caused by flying particles/splinters. They cause open globe injuries which commonly involve the anterior segment. IOFBs were seen in 11.3% of the cases and they needed immediate surgery.

Patients with open globe injuries presented early to the hospital to seek medical care. The presenting visual acuity in most eyes was 4/60-PL. Those with closed globe injuries had a better vision at presentation i.e. 6/30 or better.

The presenting visual acuity was influenced by the type of injury and not by the use of the protective gear.

A majority of the cases had no previous eye examination. Nearly 1/3rd of the workers were not aware of the possibility of eye injuries.

Key Message

Potential eye hazards are found in nearly every industry and 90% of them are preventable. Mechanical injuries were the most common type of injury. Activities should be undertaken to create awareness about the risks of injuries that may be sustained and also plans should be drawn up to avoid them.

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