Molten metal-related ocular thermal burn: report on two cases

Abstract

We report two cases of severe thermal burns on the ocular surface and its adnexal appendages that developed secondary to exposure to molten heavy metal with a melting temperature of near-thousand degree Celsius. Despite aggressive intervention and strict monitoring, the profound inflammation caused significant damage to the ocular surface, ending up in an intractable infection with an unfavorable outcome. The heat of the molten metal at impact, the heat-retaining capacity of the heavy metal, the total area of the ocular surface exposed to the molten metal, and the duration of exposure determined the severity of the injury. The unfavorable outcome, despite an intensive treatment, in terms of visual acuity and cosmetic appearance, should be explicitly explained to the patient, and a psychiatrist consultation should be considered if necessary.

Contact corneal thermal burn from domestic electric clothes iron in a female teenager: A case report

“…After raising the temperature to 59°C for 15 min, diffuse corneal stromal edema and endothelial cell loss were observed. Arici et al [4] had in a case series reported two cases of severe thermal burns on the ocular surface and its adnexal appendages that developed secondary to exposure to molten heavy metal with a melting temperature of near 1000°C (893°C and 1045°C). Despite aggressive intervention and strict monitoring, the outcomes were unfavorable, as both patients developed extensive symblepharon, corneal conjunctivalization, and phthisis bulbi.…”

“…[1][2][3] Thermal ocular burns most commonly result from accidents associated with firework explosions, gasoline explosions, flames, steam, boiling water/liquid, hot tar, or molten metal (commonly aluminum). [1,2,4] Ocular thermal burns are among the most severe ocular surface injuries and may lead to limbal stem cell deficiency. [1,3] The severity of tissue destruction and impact on vision in ocular thermal injury depends on at least five factors: Temperature of the agent, heat-retaining capacity of the material, duration of contact, area over which the heat is applied, and conductance of the tissue.…”