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| ARTICLES |
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| Year : 1972 | Volume
: 20
| Issue : 4 | Page : 179-180 |
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Keratopathy due to sea water
CM Sarma
Department of Ophthalmology, Government Hospital, Masulipatnam, (A.P.), India
Correspondence Address:
C M Sarma
Department of Ophthalmology, Government Hospital, Masulipatnam, (A.P.)
India
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 4546099 
How to cite this article:
Sarma C M. Keratopathy due to sea water. Indian J Ophthalmol 1972;20:179-80 |
Fisherman's Keratopathy (Surya Prasada Rao [1] ) a variety of degeneration of the cornea, confined to that group of fishermen, engaged in deep sea fishing, commonly seen among the fishing folk of Visakhapatnam, on the east coast of India, and salt pan keratitis (Venkata Swamy [2] ) a variety of corneal dystrophy, confined to those who work in salt fields, commonly seen in and around Tuticorin, are occupational diseases.
Masulipatnam is on the east coast of India. Deep sea fishing and salt industry are occupations in and around this place, where a large number of people are employed. During the last two years, we had fifteen cases of keratopathy due to salt water, attending the ophthalmic O.P.D.
Out of the fifteen, six worked in salt fields regularly. Out of these six, two were females between the ages of 20 and 25 years and four were males between 35 and 40 years. The remaining nine were fishermen between the ages of 40 and 50 years.
Of the fifteen cases, the condition was unilateral in ten cases and bilateral in five cases and all those with bilateral involvement were workers in salt fields.
All the patients complained of pain in the eye, lacrimination and burning sensation. In addition, defective vision was complained of, by those five patients with bilateral involvement.
The clinical picture in these cases was typical. The anterior segment of the eye was normal except for corneal lesions and slight ciliary flush. The corneal lesions were central or para central, mostly in the exposed part of the cornea, disc shaped, greyish white in colour, situated deep to the corneal epithelium and Bowman's membrane, located in the substantia propria. Corneal sensation was impaired over the lesion and the area of the cornea involved appeared to be thickened. Staining with flourescein showed that corneal epithelium was intact. Vascularity of the cornea was not noticed in any case.
General condition of the patients did not reveal anything abnormal, regarding general health and nutritional status. Routine investigations did not reveal anything abnormal. Ocular tension was within normal limits in all cases.
The following treatment was adopted in all the cases. 1% Atropine eye ointment twice daily, Terramycin eye ointment twice daily, and Vitamin C. 500 mg. once daily. Scraping of the disc shaped corneal lesions was done in all the cases.
The above treatment resulted in noticeable improvement in all cases. Pain, lacrimation, and burning sensation became less and there was improvement in vision within a fortnight. In ten cases a thin residual corneal opacity was left.
| Discussion | |  |
Fisherman's Keratopathy and salt pan Keratitis, though described separately appear to be the one and same type of corneal, dystrophy. This variety of corneal dystrophy, is an occupational disease, seen after five years or more of sea life or work in salt fields.
In the case of fishermen, the corneal dystrophy affects those who regularly go out to sea for fishing some times to a distance of ten miles. These people come into intimate contact with salt water or its froth and foam which constantly splashes into their face and eyes. Salt water or brine is a chemical irritant and a hypertonic fluid containing salts of sodium, potassium and magnesium in it. These individuals also get exposed to solar radiation in the form of reflected sun light from the surface of the sea.
In salt fields, workers come into intimate contact with salt water which gets highly concentrated as it goes from one pan to the other pan. Also these pans contain crystals of sodium and magnesium which reflect strong sun light.
Fishermen and workers in salt fields are active during summer and this is the period when they are very much incapacitated. Due to forced rest during rainy season, they get relief from symptoms and these recur again after the individual resumes his activities at sea or salt field. A minimum period of five to ten years of sea life or work in salt fields appears to be necessary for the onset of this type of corneal dystrophy.
| Summary | | |
A type of corneal dystrophy, seen in fishermen and workers in salt fields is described and the aetiological factors discussed.
| References | | |
| 1. | Surya Prasada Rao, R.: Fisherman's Keratopathy-J. All India Ophthal. Soc. 10, 56-59 (1961).  |
| 2. | Venkata Swamy, G.: Salt Pan Keratits-J. All Inda Ophthal. Soc. 16, 249-250 (1968). |
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