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    Non Mechanical and Chemical Injuries

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    Muaz Abdullah
    Chemical, thermal, electrical, and radiation injuries can damage the eye. Chemical injuries include alkali and acid burns from domestic, agricultural, or laboratory accidents. Alkalis are more severe and penetrate deeply, causing total tissue necrosis. Acids have less penetration but can cause immediate coagulation and barrier formation. Treatment focuses on irrigation, antibiotic drops, steroids, lubricants, and prevention of complications like symblepharon. Thermal injuries depend on severity but are generally treated with atropine, steroids, antibiotics, and lubricants. Electrical injuries cause conjunctival congestion, corneal opacities, iris inflammation, and later electric cataract. Radiational injuries involve photokeratitis, solar macular

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    Non Mechanical and Chemical Injuries

    Uploaded by

    Muaz Abdullah
    606 views14 pages
    Chemical, thermal, electrical, and radiation injuries can damage the eye. Chemical injuries include alkali and acid burns from domestic, agricultural, or laboratory accidents. Alkalis are more severe and penetrate deeply, causing total tissue necrosis. Acids have less penetration but can cause immediate coagulation and barrier formation. Treatment focuses on irrigation, antibiotic drops, steroids, lubricants, and prevention of complications like symblepharon. Thermal injuries depend on severity but are generally treated with atropine, steroids, antibiotics, and lubricants. Electrical injuries cause conjunctival congestion, corneal opacities, iris inflammation, and later electric cataract. Radiational injuries involve photokeratitis, solar macular

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    2. Non Mechanical and Chemical Injuries

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    Chemical, thermal, electrical, and radiation injuries can damage the eye. Chemical injuries include alkali and acid burns from domestic, agricultural, or laboratory accidents. Alkalis are more severe and penetrate deeply, causing total tissue necrosis. Acids have less penetration but can cause immediate coagulation and barrier formation. Treatment focuses on irrigation, antibiotic drops, steroids, lubricants, and prevention of complications like symblepharon. Thermal injuries depend on severity but are generally treated with atropine, steroids, antibiotics, and lubricants. Electrical injuries cause conjunctival congestion, corneal opacities, iris inflammation, and later electric cataract. Radiational injuries involve photokeratitis, solar macular

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    606 views14 pages

    Non Mechanical and Chemical Injuries

    Uploaded by

    Muaz Abdullah
    Chemical, thermal, electrical, and radiation injuries can damage the eye. Chemical injuries include alkali and acid burns from domestic, agricultural, or laboratory accidents. Alkalis are more severe and penetrate deeply, causing total tissue necrosis. Acids have less penetration but can cause immediate coagulation and barrier formation. Treatment focuses on irrigation, antibiotic drops, steroids, lubricants, and prevention of complications like symblepharon. Thermal injuries depend on severity but are generally treated with atropine, steroids, antibiotics, and lubricants. Electrical injuries cause conjunctival congestion, corneal opacities, iris inflammation, and later electric cataract. Radiational injuries involve photokeratitis, solar macular

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 14

    Ocular Emergency

    Chemical Injuries
    Non-Mechanical Injuries
    Chemical Injuries

    • Mainly comprise of alkali and acid burns


    Modes of chemical injury
    Domestic accidents Ammonia, solvents, detergents &
    cosmetics
    Agricultural accidents Fertilizers, insecticides, toxins of
    vegetable & animal origin
    Chemical laboratory accidents Acids and alkalies
    Deliberate chemical attacks Acids to disfigure the face
    Chemical warfares injury -
    Self-inflicted chemical injury Seen in malingerers & psychopath
    Alkali Burns
    Alkalies dissociates & saponify fatty
    • Most severe chemical acids of cell membrane
    injuries (Destroy structure cell membrane)

    Common Alkalies
    Being Hygroscopic  extract water
    •Lime (CaO) from cell  total necrosis
    •Caustic Potash/ Caustic
    Soda (KOH)
    •Liquid ammonia They Combine with lipids of cell 
    form soluble compound
    (softening & gelatinization)

    Increased deep penetration


    of alkalies into tissues
    Clinical features
    1. Stage of acute ischaemic
    necrosis
    • Conjunctiva : marked edema,
    congestion, copius purulent
    discharge
    • Cornea : widespread sloughing
    of epithelium, edema
    • Iris : inflamed

    2. Stage of reparation
    • Conjunctiva and cornea regenerate
    • Corneal vascularization
    • Inflammation subsides

    3. Stage of complications
    • Development of symblepharon, recurrent corneal ulceration, complicated cataract,
    secondary glaucoma
    Acids Burn
    • Less serious than alkali • Chemical Effect
    burns
    Instant
    coagulation of
    all proteins
    Common acid
    •Sulphuric acid
    •Hydrochloric acid
    Act as barrier
    •Nitric Acid

    Prevent deep
    penetration of acid
    into tissue
    • Clinical features
    – Conjuntiva

    Immediate Symblepharon
    Sloughing
    necrosis (fibrosis)

    – Cornea
    • Necrosis and sloughed out

    Mild to • Corneal
    opacification of
    moderate varying degree

    • Whole cornea may


    Severe slough out
     staphyloma
    Roper-Hall classification
    --Grades of chemical burns--
    Visual
    Grade Corneal Appeareance Limbal Ischemia
    Prognosis

    I • Clear cornea Nil Excellent

    • Hazy
    II <1/3 Good
    • Iris details visible

    • Opaque cornea Doubtful/


    III 1/3 to half
    • Iris details obscured Guarded

    • Opaque
    IV • No view of iris and >half Poor
    pupil
    Treatment
    • Prevent further damage
    – Immediate and thorough irrigation with clean
    water or normal saline
    • NS (2L) for 20-30 min or until achieve normal pH
    – Mechanical removal of contaminant using swab
    stick
    – Removal of contaminated & necrotic tissue
    • Maintenance of favourable condition
    (rapid & uncomplicated healing)
    – Topical antibiotics drops (moxifloxacin 4-6 per
    day)
    – Steroid eyedrops
    – Cycloplegics (atropine)
    – Ascorbic acid (in form of 10% sodium ascorbate
    eyesdrops)
    – Lubricant eyedrops
    – Autologous serum
    – Sodium citrate ( 10% Topical eyedrops)
    – Doxycycline 100 mg BD
    • Prevention of symblepharon
    – Slide piece of glass in between
    the 2 surfaces for 2-3 times/day
    until inflammation subside

    • Treatment of complication
    – Secondary glaucoma
    – Poor corneal healing
    – Pseudopterygium
    – Symblepharon
    – Corneal opacity
    Non-mechanical Injuries

    Thermal
    Electrical
    Radiation
    Thermal Injuries
    • Usually caused by fire / hot
    fluids
    • Severe case, conjunctiva &
    cornea may be affected

    Treatment:
    • If only lids, general
    treatments of burns
    • If cornea, treated with
    atropine, steroids,
    antibiotics & lubricants
    Electrical Injuries
    • Caused by passage of strong current from
    the area of eyes

    • Clinical features :
    • Congested conjunctiva
    • Cornea : punctate / diffuse interstitial
    opacities
    • Inflamed iris & ciliary body
    • May develop ‘electric cataract’ after 2-4
    months
    • Multiple hemorrhages on retina
    • May develop optic neuritis
    Radiational Injuries
    1. Ultraviolet radiations :
    • may cause photopthalmia &
    responsible for senile cataract
    2. Infrared radiations :
    • may cause solar macular
    burns
    3. Ionizing radiations :
    • following radiotherapy to the
    tumors in the vicinity of the
    eyes (keratoconjunctivitis,
    dermatitis of lids, cataract,
    retinopathy)

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