Welcome to question of the day #196

Welcome to question of the day #196

What’s a good way of identifying which of my patients are at risk of ocular trauma?

I recently read an article about optometrists triaging and treating patients with ocular trauma in accident and emergency hospitals in Belfast, Northern Ireland, and in London, UK.

The most common causes of ocular damage were blunt trauma from alcohol-induced fighting on Friday and Saturday nights, chemical injuries, home improvements, and sport. From my own experience of observing in an accident and emergency eye department when I was training, I’d like to add gardening and working in the construction industry. Garden-related injuries boomed at the start of spring. People went back out into their gardens and couldn’t find their eye protection and got injured. Others didn’t realise that some of their plants had grown and were occupying space they hadn’t done before so got injured. Others were painting fences, sheds, benches, and chairs with all forms of chemicals, which were harmful when entering the eye, and using a lawnmower can result in hard debris being fired into an eye. These are some of the reasons I’m reluctant to do any work in my own garden.

In order to identify which of your patients are at risk of ocular trauma, I suggest you ask if they:

Play squash, badminton or golf.

Work in the construction industry.

Work with chemicals.

Need to hit metal with metal.

Working on vehicle repair or maintenance.

Fish (angling).

Anyone that answers yes to at least one of these questions should be given advice about ocular protection and this advice noted in the clinical records. You may want to recommend over shields, sports goggles and/or polycarbonate lenses.

Anyone that spends any time working in a garden should be reminded of the potential dangers with that environment especially at the start of and during Spring.

We can’t help reduce alcohol and fighting-induced ocular trauma but if you can ask patients these questions you will save a lot of discomfort and anxiety and probably prevent some catastrophic sight loss.