Corneal and Conjunctival Burns

The degree of damage to the cornea and conjunctiva from acid or alkali etching depends on the exposure time and the concentration of the caustic.

• the acids cause coagulation necrosis , which prevents deep damage to the cornea
• the principles cause colliquative necrosis , which goes deep and causes more serious injury

The most common substances that cause burns

• • lime
  • sulfuric acid
  • hydrochloric acid

Injury Description

• • minor injuries cause necrosis of the corneal epithelium and occlusion of the perilimbal vessels, which prolongs or hinders healing
  • severe injuries cause necrosis of the cornea and sclera

Visible changes

• pseudopterygium – a fibrovascular membrane that grows over the clouded cornea
• symblepharon – adhesions between the lid and bulbar conjunctiva as a result of conjunctival scarring
• ectropion – scarring causes the edge of the lids to turn away from the bulb
• trichiasis – eyelashes turn against the bulb and thereby traumatize the conjunctiva and cornea
• inflammatory uveal reaction
• secondary glaucoma

Degrees of etching

• • 1st degree : congestion of the eyelids, conjunctivae, mucous secretion, erosion of the eye surface (heals ad integrum)
  • 2nd degree : previous signs, in addition blisters and the formation of ischemic foci (small corneal opacities remain, possibly symblepharon)
  • 3rd degree : skin necrosis, ischemic changes, vessel occlusion, boiled fish eye - clouded cornea (prolonged healing, dry eye, corneal vascularization)
  • 4th degree : charring (loss of the eye)

First Aid

• • remove the caustic with any suitable solution
  • mechanically clean the eyelids, cornea, conjunctivae
  • transfer to the eye clinic: prevent secondary infection - application of ATB, corticosteroids (used only in the first phase of healing)
  • treatment of eyelid position, symblefares, pseudopterygia, trichiasis
  • in case of damage to the lacrimal apparatus and lack of tears, the application of artificial tears

Links

Related Articles

• Eye
• Eye examination. Distribution of basic faults by perimeter

References

• ROZSÍVAL, Pavel, et al. Ophthalmology. 1st edition. Prague: Galén, 2006. 373 pp.  ISBN 80-7262-404-0 .