Ocular burns constitute true ocular emergencies and both thermal and chemical burns represent potentially blinding ocular injuries.
Chemical exposure to the eye can result in rapid, devastating, and permanent damage and is one of the true emergencies in ophthalmology;Separate alkaline from acid chemical exposure:Alkaline burns - more severe, alkali penetrates and saponifies tissues easily, may produce injury to lids, conjunctiva, cornea, sclera, iris, lens, and retina;Acid burns - usually acid does not damage internal structures since protein coagulation limits acid penetration. Ocular Chemical Burns is chemical exposure to the eye can result in rapid, devastating, and permanent damage. Ocular burn injuries are classified by etiologic agents as either chemical injuries or radiant energy injuries. Ocular burn severity correlates directly to exposure duration and the causative agent. In particular, chemical burn severity relates to the solution pH, contact duration, solution quantity, and solution penetrability. Burns damage tissues primarily by denaturing and coagulating cellular proteins and secondarily through vascular ischemic damage. Ocular burns represent 7-18% of ocular traumas presenting to EDs.Symptoms • Mild burns:• Pain and blurred vision• Eyelid skin erythema and edema• Corneal epithelial defects or superficial punctate keratitis• Conjunctival chemosis, hyperemia, and hemorrhages without perilimbal ischemia• Mild anterior chamber reaction• Moderate to severe burns: Alcalis are lipophilic substances and penetrate faster than acids. Saponification fatty acids cell membrane of the cells causing the disruption and death. Causing burns acid protein coagulation in the corneal epithelium, which limits further penetration. Épithéliales injury results in a punctate keratitis. The injuries to the eyes represent 3-4% of all occupational injuries. Adults and children are almost as exposed to chemical burns.Alkaline burns occur more frequently and are generally more severe than acid burns. These solutions destroy the cell structure not only of the epithelium but also of the stroma and endothelium.While acids create a first, and then stop burning, alkalis may continue to penetrate the cornea long after the initial trauma. The sources Alkali include ammonia, lye and lime. A chemical burn requires immediate attention. The patient needs fast, fluid copious irrigation of the eye affected, especially with alkaline trauma. Conjunctival autograft or limbal transplantation of stem cells epithelial restoration. Lamellar or penetrating keratoplasty for the tectonic stabilization or vision rehabilitation. Topical corticosteroids should be used with caution in the presence of the epithelium of the cornea damaged iatrogenic infection can occur.