Exposure of the eye to any chemical
can cause significant damage to the anterior segment.
Industrial agents containing alkali
or acid are especially devastating to the eye. Alkalis are
more dangerous than acids.
Chemical burn is one condition where
immediate treatment should precede examination as
the amount of damage is related
to the duration of the exposure.
Wash the eye with copious amounts of
water with the eye open.
If the patient had severe blepharospasm
instill topical anaesthesia and continue
If the burn is caused by household detergent
and there was minimal discomfort then
referral is not necessary
If the burn is caused by industrial
agents or any unknown agents, refer the patient to
the eye casualty immediately
In the casualty, the pH of the eye is
measured (normal pH is around8). If the pH is too
high or low further irrigation is
The severity is assessed by the degree
of corneal opacities and limbal ischaemia
(whiteness around the cornea)
An eye with severe chemical burn
showing opacification of the cornea and whiteness
around the corneal (limbal ischaemia).
Immediate washout is the most important first
step. Further treatment involves
reducing the inflammatory process with topical steroid
and the use of topical and systemic
vitamin C to enchance healing.
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