dr. ANDREAS SURYA ANUGRAH, Sp.M
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Incidence Of Photokeratitis In Factory Workers After Ultraviolet C Exposure and Its Management : A Case Series: Poster Presentation - Case Series - Ophthalmologist dr. ANDREAS SURYA ANUGRAH, Sp.M; dr. Rima Melati, M.KK, SpAk(K), Sp.Ok(K)
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/pj540m50

Abstract

Introduction : Ultraviolet C lamps have been used in industry and healthcare to disinfect rooms, air, water, and surfaces. However, exposure to UV-C may cause serious damage to human eyes. Case Illustration : This were photokeratitis case series of 4 factory workers that occurred simultaneously after 4 hours exposure to UV-C lamp about one meter away without any protective eyewear. Several hours after exposure, they complained swollen, red and watery eyes, photophobia, sandy sensation, and blurry vision. One day after, they were taken to the Emergency Unit. Diagnosis of photokeratitis was established by using biomicroscopic examination. All subjects were treated with antibiotic eye drops, lubricants, oral anti-inflammatory drugs, and cold compress. Evaluation after 1 week showed clinical improvement and all subjects were able to return to work normally. Discussion : Photokeratitis or ultraviolet keratitis is an inflammatory condition of the cornea after ultraviolet exposure for 30 minutes to 12 hours. The corneal epithelial layer functions as protector for corneal stroma and endothelium. However, the longer corneal epithelium is exposed to ultraviolet light, the more damaged it is. This caused subepithelial nerve plexus exposed, resulting in severe pain, photophobia, and bilateral epiphora. Injection and chemosis of bulbar conjunctiva, epiphora, and punctate keratopathy of cornea were found in examination. The management given is supportive therapy, and should be immediately given until corneal epithelium healed. Conclusion : Photokeratitis may occurred in daily work. Regulation, warning, training and appropriate protective eyewear for workers in workplaces using UV-C lamps are mandatory. Immediate and adequate treatment can save the sight of workers exposed to UV-C.
The Importance of Initial Management in Ocular Chemical Burn: A Case Series: Poster Presentation - Case Series - Ophthalmologist dr. ANDREAS SURYA ANUGRAH, Sp.M; dr. Reny Setyowaty, Sp.M
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/ezp4nr16

Abstract

Introduction : Ocular chemical injuries are true emergency which requires immediate intervention. Delayed management may result in severe eye injuries. This report aims to describe the effectivity of initial management and medical treatment of ocular chemical burns. Case Illustration : We reported four cases of ocular chemical injuries due to alkaline, acidic, and unspecified chemical compound. All subjects were men, aged 30 to 50 years old. They had injuries at work and none of them used eyewear protector. Each was brought to emergency unit in less than 2 hours. They were given initial timely irrigation until pH neutralized. Ocular damages were evaluated using Roper-Hall Classification, three cases were Roper-Hall 2 and other was Roper-Hall 3. After initial management, all cases were treated with medical treatment and showed significant improvement. After 6 months follow up, there weren’t any long-term sequelae in all subjects. Discussion : Serious eye damage results from strongly alkaline or acidic compounds. Most critical factor is timely delivery of irrigating fluid. Irrigation should ideally be performed with isotonic saline or lactate ringer solution and continued until the pH neutralized to a physiological level. Any method of irrigating the eye is preferable than delay in elimination of the destructive chemical. Medical treatments in acute management of severe ocular chemical burns are anti-inflammatory therapy, halting epithelial and stromal breakdown, promoting re-epithelialization and promoting corneal stromal healing. Conclusion : Timely irrigation of the eye effectively reduces severity of chemical burns, reduces need for surgical intervention, and improves final visual acuity if combined with medical treatment in golden period.