Ocular Injuries from Household Chemicals: Early Signs as Predictors of Recovery

Abstract

We undertook a study of patients with nonsevere ocular injuries from chemicals used in the home to (1) establish the frequency of presentation to the Accident and Emergency (A&E) Department; (2) assess and grade any common symptoms and signs of injury; and (3) evaluate cytokine concentrations in the preocular fluid as markers of toxicity. Of the 216 reviewed chemical injuries, 85% were sustained by adults (twice as many men than women). Chemicals implicated were: alkalis, cleaners, organic solvents, personal hygiene products, contact lens solutions, and disinfectants. Conjunctival redness occurred in 80% of cases, irrespective of chemical. Low correlations were obtained for the extent, type, and degree of epithelial damage in different areas of the lower lid and bulbar conjunctiva. With one exception, interleukin (IL)1β and IL10 levels were not different in control and injured eyes, whereas IL6 was significantly elevated above uninjured levels. We have shown that interleukins, as representatives of signal chemicals, can be noninvasively sampled and reliably measured in tears after chemical injury. An indication of injury is obtained clearly from IL6 levels in tears, and there is a hint that the pattern of IL1β/IL10 might help discriminate between levels of severity. A larger study is needed to verify these results.