Slaked lime is an alkali compound broadly used as a binding agent, together with betel nut and different components, to make paan within the Indian subcontinent. A new study has discovered that chuna is a main trigger for ocular burns amongst kids, together with family chemical substances and fireworks.
The study paper was revealed within the July 2023 version of the Indian Journal of Ophthalmology. It was carried out by researchers on the L.V. Prasad Eye Institute, Hyderabad, and Narayana Nethralaya, Bengaluru.
Loosely bought in plastic packets, the quicklime can puff out of the packet on to a baby’s eyes. The alkali then burns the ocular floor and can lead to eye harm.
Ocular burns due to family chemical substances are wholly avoidable. They are a tragic reason behind ocular morbidity, even imaginative and prescient loss, particularly amongst kids.
What is chuna and what are its dangers?
Indian paan has slaked lime, or chuna (sunnam in Telugu; sunna in Kannada; sunnaampu in Tamil), smeared onto a betel leaf and is chewed together with areca nut. Tobacco can be added to the paan and the alkali quickens its absorption. Paan consumption, particularly in South and South East Asia, has been reported from prehistoric instances.
Chuna is usually bought in unfastened and poorly sealed packets throughout the area.
An exploding packet of chuna can ship the alkali straight into a individual’s eye, with the chemical lodging itself contained in the eyelid and coating the cornea, the outer clear layer of the attention. Here, the alkali chemically burns by means of the fragile tissue, inflicting in depth harm.
The rim of the cornea, known as the corneal limbus, is residence to specialised stem cells that replenish the cornea. Chemical burns can destroy the limbus, in flip compromising the cornea’s skill to restore itself.
The risk of chemical harm to the attention just isn’t restricted to slaked lime. Household cleansing brokers like rest room cleaners and different acids, in addition to fireworks and even super-glue in tubes, are all liable to trigger ocular harm.
Chemical burns to the attention ends in ocular burns or, in worse instances, extreme lack of imaginative and prescient. They could require in depth surgical intervention, together with stem-cell transplantation and corneal grafts, and can want lifelong administration. Alkali burns can have a poor prognosis and interventions typically restore sight solely to a restricted extent.
Who is at risk?
Children with entry to family chemical substances like chuna, adults who work with such brokers with out protecting eye glasses, and people of each age-groups once they play with firecrackers are at risk of ocular burns.
Manysmall research and studies have flagged chuna-related ocular burns, particularly in kids. The new study – one of many largest of its form in India – provides insights into who’s at risk and the first causes of ocular burns.
For the study, researchers obtained the scientific profiles of 271 kids (338 eyes) and 1,300 adults (1,809 eyes) who introduced to the L.V. Prasad Eye Institute and the Narayana Nethralaya hospitals with acute ocular burns (AOB).
“Both the hospitals in this study are tertiary referral centres, so they are not the first stop for patients with ocular burns,” Swapna Shanbhag, marketing consultant ophthalmologist on the Institute and one of many corresponding authors of the study paper, stated. “For this study, we defined patients who presented to these centres within one month of injury as ‘acute’.”
“Patients who present later are ‘chronic’, and their outcomes are even poorer,” she added.
Chuna most typical alkali agent
The researchers discovered that a majority of individuals with AOB have been male (over 80% amongst adults and over 60% amongst kids), and that alkalis accounted for 38% of all ocular burns – and as a lot as 45% of all burns in kids.
While the study discovered that the bodily or chemical brokers answerable for the burns diversified between kids and adults, chuna was the most typical alkali agent in each teams, inflicting 32% of all alkali burns amongst kids and seven% amongst adults. Some 17% of kids introduced with thermal burns (due to fireworks) and one other 14% had squirted superglue into their eyes. Acids, like toilet-cleaning or surfacing-cleaning liquids, additionally triggered burns in each kids and adults.
More than 60% of the youngsters had low-grade burns and benefited from medical remedy. At the identical time, sadly, the fraction of people with higher harm, continual problems, and poorer visible outcomes was increased amongst kids.
What preventive measures are wanted?
All these accidents could be averted if the substance inflicting them is saved safely, away from the attain of kids. Adults who’re at risk of office accidents – since lime can be current in whitewash, for instance – will profit from protecting eye glasses.
The study additionally underscores the necessity to enhance the packet integrity of chuna bought over-the-counter. Better high quality plastic and sealing and clear warning messages on the packet could assist cut back the dangers to kids. People ought to solely buy adequately sealed packets of alkalis and acids, and demand on utilizing them with protecting glasses.
Firecrackers are a recognized risk for burns, and folks ought to be made conscious of the risk of ocular harm as properly. All the standard security measures – sourcing good-quality firecrackers, utilizing them in open areas the place bystanders, particularly kids, are at a protected distance – apply.
Finally, a key discovering of this study is that shut to 60% of all sufferers with ocular burns didn’t current to a hospital inside 24 hours. It additionally discovered that greater than 20% of the sufferers didn’t obtain any eye wash once they reached, or earlier than reaching, emergency care.
It is crucial that the burnt eye is instantly washed off the chemical as quickly because the harm occurs. When the affected person visits a hospital, the attention should even be completely irrigated to take away any substances that could be lodged within the eye.
Tejah Balantrapu is the affiliate director of Science, Health Data, and Story-telling on the L.V. Prasad Eye Institute.
