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Chemical injuries emergency
Chemical injuries to the eye can be caused by both acids and alkalis, though alkalis are more common. Alkalis penetrate more deeply than acids and can cause damage to structures in the eye including the lids, conjunctiva, cornea, anterior chamber, and ciliary body. Management of chemical injuries involves emergency irrigation and debridement followed by medical treatments like antibiotics, steroids, and ascorbic acid to reduce inflammation and promote healing. More severe injuries may require surgical interventions like conjunctival grafts, correction of eyelid deformities, or keratoplasty to repair damage from the chemical burn.
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Chemical injuries emergency
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- 3. Introduction • Alkali ismore common than acid • Alkalis penetrate more deeply than acids • Common alkalis = ammonia, sodium hydroxide and lime • Common acids = sulphuric, sulphurous, hydrofluoric, acetic, chromic and hydrochloric
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- 8. Damage Structure Damage Lids Cicatricialentropion Conjunctiva Necrosis, symblepharon fromation Cornea Necrosis, stromal opacification, vascularization, perforation Anterior chamber Iiris and lens damage Ciliary body epithelial damage= Impairs secretion of ascorbate
- 10. Management • Emergency management •Medical treatment • Surgery
- 11. Emergency management • Copiousirrigation • Double eversion of the upper eyelid • Debridement of necrotic areas of corneal epithelium • Admission
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- 14. Debridement • Debridement ofnecrotic areas of corneal epithelium promote re-epitheliazation and remove associated chemical residue
- 15. Admission • Required forsevere injuries in order to ensure adequate eye drop instillation in the early stages
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- 17. Management AIM • Reduce inflammation •Promote epithelial regeneration • Prevent corneal ulceration
- 18. Cont. • Cycloplegic • Topicalantibiotics • Topical steroids • Oral analgesics • Tetracycline • Control IOP • Ascorbic acid • Citric acid
- 19. Surgery AIM • Promote revascularizationof the limbus • Restore the limbal cell population • Re establish the fornices
- 20. Early • Advancement oftenon’s capsule and suturing to the limbus • Limbal stem cell transplantation • Amniotic membrane grafting • Gluing or keratoplasty
- 21. Late • Division ofconjunctival bands and treating symblepharon • Conjunctival grafts • Correction of eyelid deformities • Keratoplasty • keratoprosthesis
- 22. Recap • A 22year old female came to the opd complaining harpic solution in the right eye in the morning. • On examination VA 6/12 and 6/6.she had chemosis and corneal oedema was present with iris visible.
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