Chemical Ocular Burns
Introduction
Chemical ocular burns occur when a person is exposed to any kind of caustic chemical, such as alkalis, acids, solvents, detergents, and bleaches. Ocular burns are serious medical emergencies and can lead to permanent vision loss, if not treated in time. The purpose of this article is to provide an overview of chemical ocular burns and to highlight the importance of early recognition and treatment.
What are Chemical Burns?
Chemical burns occur when caustic/corrosive chemicals come in contact with the eye. These substances can be either acidic or alkaline in nature. Acids are substances that have a pH of less than 7, while alkalis are substances with a pH greater than 7. Common examples of acids that can cause ocular burns include hydrochloric acid (HCl) and hydrofluoric acid (HF). Common examples of alkalis include sodium hydroxide (NaOH) and potassium hydroxide (KOH). Other caustic chemicals that can cause ocular burns include solvents and detergents.
Pathophysiology
The severity of ocular burns is determined by a variety of factors. These include the type, concentration, and the duration of exposure. In most cases, chemical burns cause direct tissue damage due to their pH. Acids have a coagulating effect on tissues, while alkalis cause liquefaction necrosis. This means that alkaline substances can cause a more extensive damage as they are able to penetrate deeper layers of the tissue. Chemicals can also cause indirect tissue damage due to their ability to damage the lipid layers that line the eye, and the damage can extend beyond the exposed area of the eye.
Clinical Presentation
The initial presentation of a chemical ocular burn can vary depending on the type of chemical and the extent of the damage caused. Generally, patients may experience the following symptoms:
• Pain
• Redness
• Blurred or decreased vision
• Burning sensation
• Excessive tearing and/or discharge
• Swelling of the eyelid
• Light sensitivity
• Irritation
• Foreign body sensation
Diagnosis
The diagnosis of a chemical ocular burn is based on the patient’s history and physical examination. If the patient was exposed to a caustic chemical, it is important to identify the type and concentration of the substance as this can help guide the management and treatment. A slit-lamp examination is also important as it can help to determine the extent of damage to the ocular tissues.
Treatment
Treatment of ocular burns depends on the type and extent of the injury. Generally, the goals of treatment are to reduce pain, prevent further damage, and promote healing. In most cases, the patient will be immediately assessed and referred to an ophthalmologist.
First, the affected eye may need to be irrigated with water or saline solution. Irrigation is important in order to remove any remaining chemical from the eye. In some cases, an antibiotic eye-drop may be administered. Analgesic eye-drops may also be prescribed to reduce pain.
It is important to note that the treatment of ocular burns can vary depending on the severity of the injury. For more severe cases, intensive treatment such as surgery may be necessary.
Conclusion
Chemical ocular burns are serious medical emergencies that can lead to permanent vision loss if not treated in time. It is important to identify the type and concentration of the substance in order to guide the management and treatment. The goal of treatment is to reduce pain, prevent further damage, and promote healing.
