Napoli Pietro Emanuele, Nioi Matteo, Iovino Claudio, Sanna Raffaele, d'Aloja Ernesto, Fossarello Maurizio
Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
Department of Public Health, Clinical and Molecular Medicine, Forensic Science Unit, University of Cagliari, Cagliari, Italy.
Int Ophthalmol. 2019 May;39(5):1175-1178. doi: 10.1007/s10792-018-0915-1. Epub 2018 Mar 28.
To report the ocular surface and respiratory tract damages due to a sub-chronic (3 months), occupational exposure to fluorspar dust in case of inconsistent use of personal protective equipment.
A 50-year-old man was referred to our clinic with bilateral conjunctival injection, ocular foreign body sensation and symptoms of ocular discomfort. He reported having 3 days before an urgent hospital admission for dyspnoea with odynophagia, hyposmia, nausea, vomiting, headache and asthenia. Otorhinolaryngological examination revealed a severe hypertrophic rhinopharyngitis and a significant decrease in overall sensitivity to olfactory stimuli. General anamnesis was negative for previous diseases or medication use.
Ocular examination revealed a diffuse injection of the ocular surface with some areas of conjunctival and limbal ischaemia, a best-corrected visual acuity of 20/25 in both eyes, an intraocular pressure of 23 and 21 mmHg, respectively, in the right and in the left eyes, and a normal fundus oculi. Assessment of the tear film and ocular surface showed the presence of dry eye disease. Based on medical history and clinical tests, initial diagnostic hypothesis was ocular surface burn due to chemical exposure, i.e. to fluorspar. Therefore, anterior segment fluorescein angiography was performed to confirm the extension of conjunctival and limbal ischaemia. Thus, ocular ischaemia was detected in approximately 10 clock hours of limbus and in 50% of conjunctiva.
The present work remarks the importance of using protective equipment for preventing ocular and respiratory tract damages in workers occupationally exposed to the 'acid-grade fluorite'.
报告在个人防护设备使用不一致的情况下，因职业性长期（3个月）接触萤石粉尘导致的眼表和呼吸道损伤。
一名50岁男性因双眼结膜充血、眼部异物感及眼部不适症状被转诊至我院。他报告称，在因呼吸困难、吞咽痛、嗅觉减退、恶心、呕吐、头痛和乏力紧急入院前3天出现上述症状。耳鼻喉科检查显示严重的肥厚性鼻咽炎，对嗅觉刺激的总体敏感性显著降低。既往病史和用药史均无异常。
眼部检查发现眼表弥漫性充血，结膜和角膜缘部分区域缺血，双眼最佳矫正视力均为20/25，右眼眼压为23 mmHg，左眼眼压为21 mmHg，眼底正常。泪膜和眼表评估显示存在干眼症。根据病史和临床检查，初步诊断假设为化学物质暴露（即萤石）导致的眼表烧伤。因此，进行了眼前段荧光素血管造影以确认结膜和角膜缘缺血的范围。结果发现，角膜缘约10个钟点区域及50%的结膜存在眼部缺血。
本研究强调了使用防护设备对预防职业接触“酸级萤石”的工人眼呼吸道损伤的重要性。
