Avaliação epidemiológica dos pacientes vítimas de queimadura ocular pelo agente químico cal no Serviço de Oftalmologia do Hospital Universitário Evangélico de Curitiba

Abstract

Objetivo: Avaliar o perfil epidemiológico dos pacientes vítimas de queimadura ocular pelo agente químico cal, no Serviço de Oftalmologia do Hospital Universitário Evangélico de Curitiba, enfatizando-se os casos de queimaduras oculares pela "Bomba de Cal". Métodos: Estudo prospectivo de 88 pacientes com queimadura ocular pela cal (cal sem explosão ou bomba de cal), que procuraram o serviço de Pronto Atendimento do referido hospital no período de setembro de 1999 a setembro de 2000. Resultados: Dos 88 pacientes avaliados 73 (82,95%) foram vítimas de queimadura ocular pela cal no ambiente de trabalho e 15 (17,24%) foram vítimas da "Bomba de Cal" (brincadeira regional). A maioria dos pacientes examinados foi do sexo masculino, com faixa etária entre 20 e 40 anos, com predomínio de queimadura ocular unilateral e grau I quando vítimas de acidente de trabalho e bilateral e grau IV quando a queimadura foi resultante da "Bomba de Cal". Conclusão: Comparando-se os grupos estudados observou-se que o grupo vítima de queimadura ocular pela "Bomba de Cal" apresentou maior agravo à saúde ocular demonstrado, neste estudo, pela bilateralidade, gravidade das lesões e idade mais precoce de acometimento dos pacientes.

Skin burn and ocular damage by calcium oxide (virgin lime) in swines

“…In humans these accidents are frequent. The victims are usually of the male gender, young, and ordinarily with occurrence in the work or domestic place (Castellano et al 2002). Epithelial necrosis occurs because the hydroxide anion saponifies fatty acids from cell membranes with resulting rupture and cell death, and cation is responsible for the free alkali (McCulley 1987, Freitas 1997.…”

Atypical corneal manifestation of sterile inflammatory infiltrates after alkali ocular burn

“…Owign to their higher prevalence in everyday products, such as household cleaning agents and construction materials, accidental injuries caused by alkaline agents occur more frequently than those caused by acids [4,7,8,11,12] . The severity of ocular injury depends on the duration of exposure of the eyeball to the aggressive agent,concentration of the agent, pH of the solution, and the rate of drug penetration [1,9] . Alkalises commonly associated with ocular burns include ammonia (NH3), caustic soda (NaOH), lime [CaO or Ca (OH)2], and potassium hydroxide (KOH).…”

“…9 The hydroxide ion (OH −) saponifies fatty acids and leads to the hydrolysis of cell membranes, resulting in cellular rupture and death, facilitating the penetration of the caustic agent into tissues and causing deeper injuries. Cations react with the carboxylic groups (COOH-) of stromal collagen and glycosaminoglycans, and their hydration leads to loss of corneal stromal transparency [1,4] . When there is sufficient contact between alkaline compounds and the ocular surface, alkaline substances can be detected in the aqueous humor within 3 -5 minutes.…”

“…Chemical burns are common causes of ocular health damage and should be considered an ophthalmologic emergency due to their high morbidity [1] . In addition to injuring the ocular surface, alkalis can penetrate the eye, damaging the corneal stroma and endothelium as well as other structures within the anterior segment, such as the iris, lens, and ciliary body [1,2] .…”

“…Chemical burns are common causes of ocular health damage and should be considered an ophthalmologic emergency due to their high morbidity [1] . In addition to injuring the ocular surface, alkalis can penetrate the eye, damaging the corneal stroma and endothelium as well as other structures within the anterior segment, such as the iris, lens, and ciliary body [1,2] . Sterile corneal infiltrates are commonly observed in contact lens users and rarely reported in cases of chemical ocular burns, which can be mistaken for infectious infiltrates [3] .…”