|Year : 1968 | Volume
| Issue : 4 | Page : 210-212
Ocular injuries in rural industries
|Date of Web Publication||24-Dec-2007|
R R Doshi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Doshi R R. Ocular injuries in rural industries. Indian J Ophthalmol 1968;16:210-2
The main industries in rural areas deal with agriculture and side industries like carpentry, metal forging and dairying.
I have included in this study 275 cases noted in mofusil town areas; between 1965 and 1967.
Etiology: In villages, people get accidents mainly in field work especially, during the harvest season, when small twigs, leaves, thorns of some vegetable plants get into the eyes. Besides, pieces of wood, chips of stone, and laboratory chemicals, used for testing the quality of milk, cause ocular injuries just as frequently as in city civil life.
Any age is prone to accidents but children upto the age of ten have been excluded from this study.
People have to work leaning and bending in the field, hence, suddenly they get direct injuries on the lids or eyes, often from horns of animals.
Sex: Both sexes get injuries, but in this study of 275 cases, 182 were males and 93 females i.e. in a proportion of 2:1 approximately. [Table - 1]
Symptoms: The patients come mainly for pain in the eyes, watering, sudden dimness of vision and foreign body sensation.
Signs: As the injured person in villages make little of trival injuries, and as they have to travel long distances to reach eye clinics, they do not come up immediately after the accident or they try out some home medicines first, and later come to the hospitals, when the ocular inflammation has run out of control. This is the reason why we get more permanently blind persons from villages than from cities, where facilities for treatment are immediately available for injured persons.
The main signs noted in this series were : [Table - 2]
Perforating injuries of the eye ball were found in 4 cases, which varied from corneal perforation to total damage with loss of vitreous and lens, where nothing could save the eve.
Vision in the above cases varied from 6/12 to hand movements and the intra-ocular tension varied from 18 to 60 mm either immediately or at a later date. Seven cases had high tension (65 mm.) for a long time from the beginning.
| Treatment|| |
Cases can be divided into three groups: 1. Mild injuries, 2. Moderate injuries, 3. Severe injuries.
Mild cases included cases of conjunctival tears to corneal abrasions which needed simple treatment, like local antiseptic drops, ointment, pad and bandage for four to six days.
Moderate injury included cases with corneal infiltration to injury to lens, hence, treatment with local and systemic antibiotics and cortisone was given with moderate rest in bed.
In Severe cases like, vitreous haemorrhage, retinal haemorrhage or retinal detachment, absolute rest in bed was essential. Local and systemic treatment for haemorrhage etc., was given, surgical measures, as corneal suturing, iridectomy, paracentesis and diathermy coagulation were . administered, as required.
1. In Mild cases patients usually were symptom free in four to ten days without any visual loss.
2. In Moderate cases where more than one structures were involved, recovery was slow and took four to six weeks to have complete healing. Tissue reaction settled, but vision was impaired from 6/18 to finger counting from five metres in some cases.
3. In Severe cases, even with all the possible treatment, vision remained impaired for a long time. Study of these cases have been done upto six months. Enucleation of the eye had to be clone in some cases, where persistent irritation of the eye remained for more than 8 to 10 weeks and there was no hope of restoring useful vision.
In short, rural areas have their own problem for approach and treatment. Ignorance and poverty must feature in the consideration of a full treatment programme of ocular injuries in the villages.
| Discussion|| |
As opposed to injuries in factories and industrial concerns where a workman is exposed to a constant hazard and the hazard is of a single nature, in villages the hazards are not constant and are of different kinds and so the surprise element is greater prevalent in the villages. It is therefore impossible and even absurd to think of protective measures and to educate the villager in the use of protective glasses.
The risk of injury is proportionately less, but as nearly 80% of the Indian population is agrarian, the number of such injuries is not small, and for reasons stated above - paucity of medical help and long distances to travel to reach district hospitals - minor injuries also become grave in many instances. The only education programme in such environments is to exort the villager to consider all injuries to the eye as not negligible and to seek medical help as early as possible. All the help we can offer is to provide as many district hospitals, manned with trained paramedical staff to give reasonably good and sensible treatment and to guide them to district or civil hospitals, as the need may be, providing them with free transport facilities wherever they exist.
| Summary|| |
In rural areas, the risk of injury is proportionately less, but the total number of such injuries is not negligible because 80% of the Indian population is agrarian.
The type of injuries, though mild become more often severe because of ignorance, paucity of medical aid and transport difficulties to nearest hospitals.
The best way to minimise the dangers of such injuries, is to teach the villager that even mild injuries are not negligible and to create more rural dispensaries where the villager can go more easily for first-aid and proper guidance.
[Table - 1], [Table - 2]