Injury to eye is a major cause of vision loss or blindness. A review completed for the World Health Organisation (WHO) in 1998 estimated that eye injuries caused 1.6 million people to become blind in both eyes, 2.3 million people to develop low vision in both eyes, and 55 million people who sustained eye injuries had to limit their daily activities for more than one day a year. As in many other low- and middle-income countries (LMIC), with increased urbanisation, industrialisation, and motorisation, the risk of eye injury has been on the rise in Bangladesh. Agriculture work is considered to be a large source of eye injury as well. However, very few research studies have been conducted to estimate the cases, identify the causes and report on the socio-economic burden or consequences of eye injuries in Bangladesh.
Among the few research studies ever conducted on this issue, one reported that a rising number of road traffic injury, violence, and injury from animal lead to eye injury. The injuries arise from mechanical trauma (blunt or penetrating), chemical agents, or ultraviolet and ionising radiation. The common causes of eye injuries identified and reported previously are punches, flying pieces of material from explosions or industrial work, flying objects like bullets, darts, fireworks, ropes, chemical splashes, blows from hands, balls or other sports equipment. Eye injuries may also occur during protests, riots or violence.
Common symptoms of eye injury comprise pain in the eye, trouble in seeing, cuts or torn eyelid. In some cases, one eye does not move as well as the other or one eye sticks out of the eye socket. In some instances, an eye has an unusual pupil size or shape or there may be blood visible in the clear part of the eye. Tears and blinking cannot remove or clear "something" in the eye or under the eyelid.
A large segment of eye injuries originates from occupational exposure. There are a range of agents found in workplaces that can cause eye injuries. While many of these agents are also found in domestic living and playing environments, exposure at dangerously high levels is more common in a workplace. Traditionally, work-related eye injuries have predominantly affected individuals working outdoors, particularly in the construction, manufacturing and agriculture sectors. Adult males are reported to have the highest risk of work-related eye injuries.
According to a US estimate, more than 65,000 work-related eye injuries occur annually and around 90 per cent of these could have been prevented. Research in Australia shows that work-related eye injuries represent one fifth of all work-related injuries. Workers in construction, manufacturing and mining are reported to be at high risk there. A substantial proportion (38 per cent) of all work-related injuries in manufacturing are eye injuries and most such injuries result from foreign bodies entering the eye (71 per cent) in Australia. The garment workers and construction workers in Bangladesh may be at high risk because of the nature of work: dealing with small and moving objects.
Employers are required to provide their employees with personal protective equipment (PPE) for their eye protection. The type of PPE provided or required depends on the job and tasks. For example, safety goggles with full face protection are mostly important for welders as well as for other workers where the chance of foreign substances entering their eyes is high. In other industrial settings, the use of eye goggles is required for workers to protect their eyes from the incursion of foreign particles and liquids. However, such eyewear may not protect their eyes from dust, particles and vapours which can also cause eye damage. Workers spending time outdoors or driving for long time should be wearing sunglasses and hats to protect their eyes from UV radiation.
A lack of data does not help estimate the burden of eye injury. One report from the Eye Department of Sher-E-Bangla Medical College Hospital, Barisal found 18.5 per cent and 16.3 per cent of ocular injuries among total admitted patients and all operative cases, respectively for a period between December 2013 and December 2015. But there is no data on eye injuries at the national level.
However, this tertiary care facility at the national level only receives a small fraction of all eye related injuries and illness cases and cannot provide a comprehensive estimate of the real incidents and burden of eye injuries in the country.
Early reporting and immediate treatment of eye injuries can prevent serious and long-term eye impairment in most cases. Goggles and or face shield should be used for grinding, drilling, scaling and cutting activities. Treating the eyes with eyewash must be a universal and immediate approach that may help remove harmful substances. In work settings, where chemicals or small particles are frequently used or encountered, eyewash solutions must be made readily available and accessible.
Eye injuries may result in vision loss or lead to blindness. Seeking prompt medical attention after eye injury is critical to avoiding irreparable damage in the long run. Public health campaigns must create awareness among the common people about the benefits of using protective equipment for eyes because most such injuries are avoidable. Employers and workers must recognise the significance of ensuring eye safety.
Md Mahmudul Hasan and Imtiaj Hossain Chowdhury are researchers for Al-Basar International Foundation, Bangladesh.
