The magnitude and pattern of thermal ocular injuries following two major fire incidents in kenya in 2009

Abstract

OBJECTIVE:To describe the magnitude and pattern of thermal ocular injuries following two major fire incidents in Kenya in the year 2009. STUDYDESIGN: Cross- sectional analytic study METHODS: Eighty- eight patients admitted to 4 hospitals with flame burns following two oil tanker explosions were examined between 3-21 days after the incidents. All admitted patients within the study period (February- July 2009) were interviewed and examined. Information on biodata, Total Body Surface Area (TBSA) of burns, facial and ocular burns was collected and recorded on a questionnaire. Detailed ocular examination of the anterior and posterior segment was carried out and recorded on the same questionnaire, after which data was analyzed and presented appropriately. RESULTS:Males were more involved than females with a ratio of 13:1.Majority were young with a mean age of 23.9 years. The eyelids were the most affected structures (68.2%) followed by eyebrows and eyelashes (60.8%). 1st degree lid burns (40.9%) were more frequent than 2nd (23.3%) and 3rd degree burns (4.0%). The conjunctiva (20.5%) and cornea (10.2%) were affected to a lesser extent. Most patients (98.9%) had normal vision. Facial burns were present in 70.5% of patients and these had a positive association with ocular injuries. Spectrum of ocular injuries also had a positive association with TBSA, which was statistically significant. 3.9% of patients received emergency ocular treatment after the first fire incident compared to 43.2% after the second fire. CONCLUSION: Ocular adnexae are the most involved eye structures following' flame burns, with the eyelids being more commonly affected. Intraocular injury was not common and thus vision was largely preserved. Patients with facial burns and higher percentage TBSA of burn were more likely to incur ocular burns. Despite a learning curve, emergency ocular management of patients was inadequate.