Characteristics of open eye injuries in the Beirut Port explosion

Georges Sukkarieh; Corinne Lahoud; Ralph Ghorayeb; Mariana Abi Karam; Yara Succarieh; Maher Saleh; Alexandre Jalkh

doi:10.1016/j.injury.2021.07.031

Characteristics of open eye injuries in the Beirut Port explosion

Injury. 2021 Sep;52(9):2601-2605. doi: 10.1016/j.injury.2021.07.031. Epub 2021 Jul 24.

Authors

Georges Sukkarieh¹, Corinne Lahoud², Ralph Ghorayeb³, Mariana Abi Karam², Yara Succarieh³, Maher Saleh⁴, Alexandre Jalkh²

Affiliations

¹ Ophthalmology Department, Hȏtel-Dieu de France Hospital, Faculty of Medecine, Saint Joseph University, Beirut, Lebanon. Electronic address: georges.succarieh@net.usj.edu.lb.
² Ophthalmology Department, Eye and Ear Hospital International, Faculty of Medecine, Holy Spirit University, Kaslik, Lebanon.
³ Ophthalmology Department, Hȏtel-Dieu de France Hospital, Faculty of Medecine, Saint Joseph University, Beirut, Lebanon.
⁴ Ophthalmology Department, Eye and Ear Hospital International, Lebanon.

PMID: 34332709
DOI: 10.1016/j.injury.2021.07.031

Abstract

Introduction: On the 4^th of August 2020 an ammonium nitrate explosion took place at the Port of Beirut in Lebanon. The aim of this study was to present the open eye injuries caused by the Beirut Port blast, and to describe their characteristics and visual outcomes at 6 months.

Methods: Patients who suffered from open globe injuries during the Beirut port explosion were recruited. Characteristics of the ocular injuries and best corrected distance visual acuity (BCVA) were recorded at presentation and at 6 months.

Results: All included eyes (23 eyes of 19 patients) suffered from penetrating open globe injuries secondary to glass material and were operated by globe exploration + primary repair. Four of the 19 patients suffered from bilateral injuries none of whom suffered from legal blindness. BCVA at presentation was hand motion or worse in 21 of 23 eyes (91%). Seven of 23 eyes (30%) had expulsive loss of intraocular tissue, 4 of 23 eyes (17%) had retinal detachment and 4 of 23 eyes (17%) had traumatic cataracts. Ocular trama score (OTS) had a mean +/- standard deviation (SD) of 61 +/- 12. Eleven of 23 eyes (48%) had zone 2 ocular injuries and 10 of 23 eyes (43%) had zone 3 ocular injuries. At 6 months follow-up 15 of 23 eyes (65%) had a BCVA of less than 20/200. All patients with Grade 2 OTS, zone 3 injuries, expulsive loss of intraocular tissue and retinal detachment had BCVA of less than 20/200 at 6 months.

Conclusion: Open eye injuries secondary to explosions occur most frequently due to glass fragments. Most of the victims were indoors, near windows and less than 500m away of the explosion site at the time of the blast. The majority of victims have very low BCVA, a low OTS and a high ocular ZOI at presentation which reflects the danger of open globe injuries secondary to blasts. A high ZOI, a low OTS, the expulsive loss of intraocular tissue and retinal detachment seem to be predictors of worse VA at 6 months.

Keywords: Beirut Port explosion; Best corrected distance visual acuity; Ocular blast injury; Ocular trauma score; Open globe injury.

MeSH terms

Explosions
Eye Injuries* / etiology
Eye Injuries, Penetrating* / surgery
Humans
Prognosis
Retrospective Studies
Trauma Severity Indices
Visual Acuity