Virgilio Lima-Gómez1, Elizabeth Mora-Pérez. 1. Servico de Ofthalmología, Hospital Juárez de México, Instituto Politécnico Nacional 5160, Col. Magdalena de las Salinas, 07760 México, D.F., México. vlimag@aol.com
Abstract
BACKGROUND: Lid wounds are traditionally repaired at primary care centers. The intervention of the ophthalmologist is reserved for cases with lachrymal system affection. High rates of ocular injuries associated with lid wounds have been reported (61%, American series; 44%, European). The purpose of the study was to identify the rate of ocular injuries in patients with lid wounds, in order to learn whether early ophthalmic evaluation is recommended, regardless of the lachrymal system status. METHODS: A retrospective, transversal, observational, analytical, open study was carried out. STATISTICAL ANALYSIS: 95% confidence intervals (CI) for rates, z for rates, chi(2). Referrals for lid wounds between 1996 and 2002 were reviewed. The rate of ocular injuries and lachrymal system injuries was determined and compared with those reported. The rate of ocular injuries in patients with and without lachrymal system injuries was compared, and the rate of ocular injuries was compared with that of the lachrymal system. RESULTS: Fifty-five patients were included (ages 1-80 years, average 26.3 years). Nine had lachrymal system injuries (16.4%, 95% CI 6.7-26.1), 37 had ocular injuries (67.3%, 95% CI 55-79.6). The rate was similar to the American study and higher than the European study (p < 0.001). Of the patients with lachrymal system injuries, 55% had ocular injuries, and 74% of patients without it had them (p < 0.05). CONCLUSIONS: At a high rate (67.3%) of lid wounds, ocular injuries coexisted. Although a lid wound not affecting the lachrymal system may be repaired at a primary care center, early ophthalmic evaluation is recommended to rule out ocular globe damage.
BACKGROUND: Lid wounds are traditionally repaired at primary care centers. The intervention of the ophthalmologist is reserved for cases with lachrymal system affection. High rates of ocular injuries associated with lid wounds have been reported (61%, American series; 44%, European). The purpose of the study was to identify the rate of ocular injuries in patients with lid wounds, in order to learn whether early ophthalmic evaluation is recommended, regardless of the lachrymal system status. METHODS: A retrospective, transversal, observational, analytical, open study was carried out. STATISTICAL ANALYSIS: 95% confidence intervals (CI) for rates, z for rates, chi(2). Referrals for lid wounds between 1996 and 2002 were reviewed. The rate of ocular injuries and lachrymal system injuries was determined and compared with those reported. The rate of ocular injuries in patients with and without lachrymal system injuries was compared, and the rate of ocular injuries was compared with that of the lachrymal system. RESULTS: Fifty-five patients were included (ages 1-80 years, average 26.3 years). Nine had lachrymal system injuries (16.4%, 95% CI 6.7-26.1), 37 had ocular injuries (67.3%, 95% CI 55-79.6). The rate was similar to the American study and higher than the European study (p < 0.001). Of the patients with lachrymal system injuries, 55% had ocular injuries, and 74% of patients without it had them (p < 0.05). CONCLUSIONS: At a high rate (67.3%) of lid wounds, ocular injuries coexisted. Although a lid wound not affecting the lachrymal system may be repaired at a primary care center, early ophthalmic evaluation is recommended to rule out ocular globe damage.