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Corneal Burn, Emergency Medicine

Matthew A. Wheatley and Ryan A. Stroder Reviewed 06/2017
 


Basics

Description

  • Inappropriate exposure of cornea to chemicals, heat, cold, electrical, or radiant energy causing damage to the cornea and often extending to adjacent structures

  • Severity of injury rel...

Diagnosis

Signs and Symptoms

  • Severe ocular pain

  • Photophobia

  • Lacrimation

  • Foreign body sensation

  • Conjunctival injection

  • Corneal edema

  • Corneal opacification

  • Impaired visual acuity

  • Limbal blanching

  • Lens opacificati...

Treatment

Pre-Hospital

  • Irrigate at scene 15–30 min unless other coexisting life-threatening conditions require immediate transfer

  • Bring bottle of substance to hospital

  • Continuous irrigation en route to h...

Follow-Up

Disposition

Admission Criteria

  • Intractable pain

  • Increased intraocular pressure

  • Corneal penetration requiring immediate surgical intervention

  • HF acid burn; admit for 24 hr of systemic analgesia

  • Sus...

Pearls and Pitfalls

  • In chemical exposures, delay exam until eye has been irrigated

  • All patients with epithelial defects need 12–24 hr ophthalmology follow-up

  • Do not prescribe topical anesthetics for dis...

Additional Reading

  • Dargin  JM, Lowenstein  RA. The painful eye. Emerg Med Clin North Am.  2008;26(1):199–216.

  • Khaw  PT, Shah  P, Elkington  AR. Injury to the eye. Br Med J.  2004;328:36–38.

  • Ma...

Codes

ICD9

  • 940.2 Alkaline chemical burn of cornea and conjunctival sac

  • 940.3 Acid chemical burn of cornea and conjunctival sac

  • 940.4 Other burn of cornea and conjunctival sac

  • 370.24 Photokeratitis

ICD10

  • H16...

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