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Ocular Chemical Burns

Ian J. McDowell, DO Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Chemical exposure to the eye can result in rapid, devastating, and permanent damage and is one of the true emergencies in ophthalmology.

  • Types of chemical exposure:

    • Alkali burns: more ...

DIAGNOSIS

HISTORY

  • Most often, complaints of pain, photophobia, blurred vision, and a foreign body sensation

  • Important to assess chemical involved, duration of exposure, velocity of impact, and involved ...

TREATMENT

Copious irrigation and removal of corneal or conjunctival foreign bodies are always the initial treatment and paramount to minimize long-term sequelae (1),(2),(3),(4)[A]: 
  • Passively open pati...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Depending on severity of ocular injury

    • From daily to weekly visits initially

  • May be inpatient

  • If on mannitol or prednisone, consider frequent serum...

REFERENCES

1
Sharma N, Kaur M, Agarwal T, et al. Treatment of acute ocular chemical burns. Surv Ophthalmol.  2018;63(2):214–235. [View Abstract on OvidMedline]
2
Baradaran-Rafii A, Eslani M, Haq Z, ...

ADDITIONAL READING

  • Chau JP, Lee DT, Lo SH. A systematic review of methods of eye irrigation for adults and children with ocular chemical burns. Worldviews Evid Based Nurs.  2012;9(3):129–138. [Vi...

CODES

ICD10

  • T26.50XA Corrosion of unsp eyelid and periocular area, init encntr

  • T26.60XA Corrosion of cornea and conjunctival sac, unsp eye, init

  • S05.00XA Inj conjunctiva and corneal abrasion w/o fb, unsp...

CLINICAL PEARLS

  • Prompt irrigation of all chemical burns, even prior to arrival to the emergency department, is essential to ensure the best outcomes. It is impossible to overirrigate.

  • All patients with...

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