East London deliberate corrosive fluid injuries

The aims of this case series are to (1) highlight the incidence of deliberate corrosive fluid injuries (DCFI) in East London; (2) ascertain the types of substances used; and (3) grade the resulting ocular surface burns using two validated grading systems.

The Metropolitan Police 2017 Freedom of Information (FOI) requests were reviewed for DCFI. We retrospectively reviewed patient records between October 2016 and 2017 from local A&E departments for DCFI. Roper-Hall and Dua Classifications were used to classify prognoses in patients with deliberate ocular corrosive fluid injuries (DOCFI).

The FOIs demonstrated an increasing trend with the highest number of DCFI surrounding our centre. We identified 57 patients with DCFI. Based on pre-irrigation pH measurement, 54.4% (n = 31) sustained acidic; 21.1% (n = 12) alkaline and 24.6% (n = 14) unknown injuries. More than half, 66.7% (n = 38), sustained DOCFI with median presentation visual acuity (VA) 0.25 LogMAR (n = 26, IQR: 0.10-0.39) and 1 month VA 0.20 LogMAR (n = 16, IQR: 0.02-0.20). Prognosis of the worse eye using (1) Roper-Hall Classification was 55% good (Grade I-II); 23% guarded (Grade III); 23% guarded (Grade IV); and (2) Dua Classification was 23% very good (Grade I); 35% good (Grade II-III); 19% good to guarded (Grade IV); 23% guarded to poor (Grade V); and 0% very poor (Grade VI).

DCFI mostly affected young men in this cohort. Our clinical experience suggested an alarming increase in DCFI and is supported by police data. Although this patient group appears to show relatively good outcomes, legislation to prevent these attacks should be prioritised.