The Ocular Surface Chemical Burns

Abstract

Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts with simple but vision saving steps and is continued with complicated surgical procedures later in the course of the disease. The goal of treatment is to restore the normal ocular surface anatomy and function. Limbal stem cell transplantation, amniotic membrane transplantation, and ultimately keratoprosthesis may be indicated depending on the patients' needs.

Occupational-related chemical ocular injuries: an analysis of 82 patients

“…The most important factor affecting the prognosis in chemical injuries of the eye is the amount and duration of contact of the chemical with the eye [13,14]. Rapid removal of the chemical and debris from the eye by intensive washing affect outcomes [11].…”

Molten metal-related ocular thermal burn: report on two cases

“…Ocular thermal burns are among the most severe ocular surface injuries and may lead to limbal stem cell deficiency (1,4) . While mild burns heal within a few days, moderate to severe chemical and thermal burns cause ischemic necrosis of the cornea, conjunctiva, sclera, iris, and ciliary body by damaging the surface epithelium.…”

“…Ocular burns cause severe damage to ocular surface elements that provide protection against infections. Treatment in the acute period following an ocular surface burn should include topical antibiotics in an attempt to prevent opportunistic infections (4,5) . Eyelids are also damaged, the patient would require consultation with an oculoplastic surgeon if cicatricial changes ensue (5) .…”

“…A symblepharon ring should be inserted as soon as possible to prevent symblepharon formation. The largest size possible, allowing closure of eyelids, is preferable in order to prevent adhesions and shortening of the fornices without touching the cornea (4) . Several studies have reported successful treatment of ocular burns using AMT with or without limbal cell transplantation (13)(14)(15)(16)(17)(18) .…”

The Method for Selecting an Irrigation System for Emergency Treatment of Patients After Chemical and Thermal Eye Burns of the First or Second Degree With the Predominant Lesion of the Eyelids or Cornea

“…Применение новых методов визуализации рогови-цы в клинической практике, например, OКT переднего отрезка глаза, позволяет оценить в динамике структур-ные изменения роговицы в процессе течения ожогово-го повреждения глаз и повысить качество диагностики для определения дальнейшей тактики лечения [10]. При этом авторы указывают, что OКT переднего отрезка глаза использовали только при первичном обращении пациента, а анализ проводили для наиболее травмиро-ванного глаза, кроме того, дополнительно выполняли цветную фотографию с увеличением, хотя известно, что до 23% -это случаи двустороннего повреждения рого-вицы с нарушением зрения [11].…”