Abstract Listings 2024

Purpose

To examine the relationship between adnexal abnormalities and their treatment during emergency corneal admissions presenting to a tertiary centre.

Methods

This study was a retrospective, noncomparative case series that included all consecutive emergency admissions that presented to the Corneoplastics Unit of Queen Victoria Hospital over a 3-year period from 2021 to 2023. Data was collected to focus on two parts: 1) emergency admission reasons, diagnoses and any procedures undertaken 2) associated nature of eyelid, fornix, and lacrimal abnormalities; indications for treatment; and types of adnexal surgery, with respect to underlying disease.

Results

173 corneal emergency admissions were identified during the study period. Of these, 80 cases required intensive topical antimicrobial treatment only and 31 admissions required therapeutic corneal grafts. There were 28 patients that were readmitted during the three years (ranging between 2 to 6 readmissions). Overall adnexal involvement was reported in 20% (35) admissions. At the time of the presentation, 77% (27) had lagophthalmos;14% (5) had upper eyelid meibomian gland inversion; and 8.5% (3) had eyelid malposition abnormalities reported. Corneal epithelial healing was promoted by surgical correction of the associated adnexal abnormality in all such admissions.

Conclusion

Concurrent adnexal abnormalities requiring treatment are associated with at least 20% of all emergency corneal admissions. A multidisciplinary approach involving oculoplastics is therefore recommended to investigate and address any subtle contributory factors for keratitis in emergency corneal admissions.

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