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Chemical Burn M.R Manaviat MD

Chemical Burn M.R Manaviat MD. The most important ocular Emergency. Pathophysiology. 1-Necrosis of corneal&conj epithelium. 2-Loss of limbal stem cell &vasculature 3-Stromal opacification. 4-Iris and lens damage. 5-Ciliary's epithelial damage. 6-Hypotony and phythisis bulbi. Grading.

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Chemical Burn M.R Manaviat MD

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  1. Chemical BurnM.R Manaviat MD The most important ocular Emergency

  2. Pathophysiology • 1-Necrosis of corneal&conj epithelium. • 2-Loss of limbal stem cell &vasculature • 3-Stromal opacification. • 4-Iris and lens damage. • 5-Ciliary's epithelial damage. • 6-Hypotony and phythisis bulbi.

  3. Grading • 1-Clear cornea,no limbal ischemia. • 2-Hazy cornea but visible Iris detail less than 1/3 of limbal ischemia. • 3-No visible Iris details,between 1/3 &1/2 of limbal Ischemia. 4-Opaque cornea,more than ½ of limbal Ischemia.

  4. Treatment • 1-Emergency. • 2-Medical. • 3-Surgical.

  5. Emergency treatment • 1-Irrigation. • 2-Removal of F.B. • 3-Debridment of necrotic tissue. • 4-Aqueous aspiration.

  6. Medical treatment • 1-Steroids 2- Ascorbic acid • 3-Tetracycline 4-Citric acid • 5-Artificial tear 6-Fibronectin • 7-Epidermal growth factor • 8-Retinoic acid 9-Tissue adhesive

  7. Surgical treatment(Early) • 1-Limbal stem cell transplantation. • 2-Advancement of tenon capsule. • 3-Amniotic membrane grafting.

  8. Surgical treatment(Late) • 1-Division of conjunctival bands and symblepharon. • 2-Conj. and mucous membrane grafts. • 3-Correction of eyelid deformities. • 4-Keratoplasty. • 5-Keratoprosthesis.

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