Eyeworld

30 | EYEWORLD | MARCH 2020 N EWS "More education should be provided on proper medication administration as well as labeling standards," said Alena Reznik, MD. "This [finding] parallels other studies in geriatric populations indicating issues with polypharmacy, polymorbidity, and inadequate geriatric assessment," the study authors wrote. They also note that previous research (not nec- essarily related to ocular exposure) has found elderly abuse as a potential cause. Although there are other steps that oph- thalmologists can take to help patients reduce dangerous ocular exposures, there will always be injuries that eye doctors have to treat. "It's un- likely a single eyecare office or even the concert- ed efforts of doctors can do much to prevent these types of injuries. Instead, eye doctors' offices are the best resource for the treatment of these issues," Dr. Wang said. abrasions, blurred vision, visual defects, papill- edema, and lacrimation. A permanent, significant visual disabil- ity occurred in 0.15% of cases; exposure to alkali was the most common agent that resulted in a permanent, significant visual disability. Among children under age 10, 20 of them had a major outcome associated with laundry detergents and five from exposure to bleach. Among working adults, alkali exposure at the workplace was most com- monly linked to a major outcome. Pesticides were the most common reason for exposure (4.9%) among all patients, fol- lowed by wrong medication taken or given (3%) and incorrect dosing route (2%). The indication of wrong medication given was higher in those age 65 or over, increasing from a 10% incidence in those age 61 to 70 to 26% in those age 91 to 100. One common example of a wrong medi- cation taken or given was a patient who uses eye drops but inadvertently exposes their eyes to something dangerous instead of their medicat- ed drops, said Craig Heise, MD. In 93% of cases, treatment was dilute/ irrigate/wash. Seven percent received "oth- er" treatment. Four percent of patients also were administered antibiotics. Insights on the results The study sheds some light on clinical trends and practical implications for both ophthalmologists and their patients. "Most patients do well, but significant or permanent eye damage still occurs," Dr. Heise said. "Simple steps in households and workplaces, encouraged by ophthal- mologists, could probably significantly decrease these." The findings match what Ming Wang, MD, has seen in practice. "It's all too easy to uninten- tionally expose the eyes to household chemicals with things such as laundry pods. We've even had staff members who have experienced this issue in their own home," he said. In addition to the large number of young children with ocular exposure, particularly relat- ed to detergent pods, physicians were intrigued by the growing number of exposures among older patients. continued from page 28 Reference 1. Heise CW and Agarwal S. Ocular exposures reported to poison control centers from 2011 to 2015. Am J Ophthalmol. 2019;204:46–50. Relevant disclosures Heise: None Reznik: None Wang: None Contact Heise: wheise@email.arizona.edu Reznik: alena.reznik@sceyes.org Wang: drwang@wangvisioninstitute.com Tips to help reduce, prevent dangerous ocular exposures 1. Recommend that patients with young children keep detergents out of reach. 2. Advise all patients to handle laundry pods carefully. 3. Recommend that those in the workplace use eye protection if they are at risk for exposure to dangerous chemicals. 4. Help make patients aware of eye injuries caused by common offenders, including super glue, contact lens clean- ing solution, and household cleaning supplies. 5. Encourage patients to read labels closely to see if a product can be used on the face or near the eyes. 6. Suggest keeping eye drops in a safe place to avoid inadvertent eye exposure to other household chemicals. 7. Let patients know to call the poison con- trol center (800-222-1222) if an eye injury occurs with a chemical agent.

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