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Long-term ocular consequences of sulfur mustard in seriously eye-injured war veterans.

Abstract：

INTRODUCTION:Sulfur mustard (SM) has been used as a dangerous chemical warfare agent since the early 20th century. Although many descriptive studies about SM-induced ocular injuries are present in the medical literature, few of them have been conducted over a large group with serious ocular involvement. MATERIALS AND METHODS:This descriptive study was conducted on 149 severe SM-intoxicated war veterans. Ocular history, anterior and posterior segment findings using a slit lamp, and direct and indirect ophthalmoscopic findings were recorded. Severity of the disease was also recorded based on a chart of the Foundation of Martyrs and Veterans Affairs. RESULTS:Ocular complains included photophobia (73.2%), sense of decreased vision (72.5%), dry eye sensation (66.4%), foreign body sensation (61.1%), tearing (46.3%), and pain (43.0%). Slit lamp findings were meibomian gland dysfunction (MGD; 96%), blepharitis, punctal closure, trichiasis, tear break-up time, and tear meniscus layer abnormality (80% to 90%). Conjunctival disturbances included vascular abnormality, ischemia, hyperemia, subconjunctival fibrosis, and pterygium. Limbal changes were abnormal vessels, limbal tissue loss and pigment loss, and pannus formation. Corneal problems included epithelial and stromal disturbances, calcium deposition, and melting. The most frequent previous surgeries were punctal closure, lamellar keratoplasty (LK), and stem cell allograft. Severity of intoxication included mild (17%), moderate (25%), and severe (57%). CONCLUSION:Chronic blepharitis and decreased tear secretion are the 2 most important and influencing factors in progression of ocular problems in SM injuries. The more severe the initial exposure, percentage of disability, and duration of ocular involvement, the higher the likelihood of mustard gas keratopathy.

journal_name

Cutan Ocul Toxicol

journal_title

Cutaneous and ocular toxicology

authors

Ghasemi H,Ghazanfari T,Ghassemi-Broumand M,Javadi MA,Babaei M,Soroush MR,Yaraee R,Faghihzadeh S,Poorfarzam S,Owlia P,Naghizadeh MM,Etezad-Razavi M,Jadidi K,Naderi M,Hassan ZM

doi

10.1080/15569520902913936

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

71-7

issue

eissn

1556-9527

issn

1556-9535

journal_volume

pub_type

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Long-term ocular consequences of sulfur mustard in seriously eye-injured war veterans.