Poor prognosis of severe chemical and thermal eye burns: the need for adequate emergency care and primary prevention

Abstract

The epidemiology and wound healing following medical and surgical treatment of 101 patients with 131 severely burnt eyes due to chemical or thermal agents have been analyzed. Most of the accidents occurred at work (72.3%); the majority of the burns were chemical (84.2%), of which 79.8% were caused by alkalis. The long average duration of treatment on ward (5.2 +/- 4.1 months) and the high number of surgical interventions (8.0 +/- 8.0) indicate the difficulties in treatment and the delayed recovery of the affected eyes. Despite improved possibilities of immuno-suppression after keratoplasty (cyclosporin A) and new methods of surgery (Tenon plasty), the possibilities of an optical rehabilitation are still limited. A visual acuity of 6/60 or better was achieved in 39 eyes (32.2%). Immediate irrigation was reported in 56.1% of accidents at the place of work and in 42.8% of accidents sustained at home. There was a significant difference with respect to the extent of damage, the treatment on ward and the number of surgical interventions. The visual prognosis for eyes which received immediate irrigation was significantly improved. Eye protection was not used in any of the 101 cases. Spread of information is necessary for adequate emergency care for eye burns as well as for permanent employment of protective glasses in high-risk occupations.

Physiopathology of the Cornea and Physiopathology of Eye Burns

“…The expressions of eye irritation and eye burns define a variety of interactions of chemical fluids, powders, and foreign bodies when they interfere with the ocular surface [7]. In this chapter, we shall focus on the mechanistic understanding of the known facts in this field.…”

Emergency treatment of eye burns: which rinsing solution should we choose?

“…Alkali-induced eye burns require long-term treatment [29]. Despite the maximal medical efforts, in some cases it is impossible to achieve rehabilitation [11]. This study tries to qualify and quantify the effects and importance of immediate emergency rinsing of the eye.…”

Alkali Burns of the Eye: Effect of Immediate Copious Irrigation with Tap Water on Their Severity

“…Kuckelkorn et al [13] reported that the visual prognosis for chemically injured eyes that received immediate irrigation was significantly improved. In the present study, immediate copious irrigation with tap water also reduced the severity in alkali burns and improved the healing time of the injured eyes.…”

“…Chemical injuries of the eye have produced extensive damage in many patients and experimental animals [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15]. The severity and prognosis of alkali burns varied.…”