1 / 30

Offendings : 1. Solid 2. Liquid 3. Powder 4.Vapor

Chemical injuries 1. Mild irritation 2. Complete destruction of the ocular surface epithelium and corneal opacification , loss of vision and rarely loss of the eye. Offendings : 1. Solid 2. Liquid 3. Powder 4.Vapor.

livia
Download Presentation

Offendings : 1. Solid 2. Liquid 3. Powder 4.Vapor

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chemical injuries1. Mild irritation2. Complete destruction of the ocular surface epithelium and corneal opacification , loss of vision and rarely loss of the eye.

  2. Offendings:1. Solid2. Liquid3. Powder4.Vapor

  3. Materials:1.House hold alkaline agents eg: cleanersamonia detergents disinfectants2. Industry : chemicals, solvents , lye and acids

  4. The most severe chemical injuries are caused by strong alkalis and acids.

  5. Alkali BurnsStrong alkalis raise the PH of tissues and cause saponification of fatty acids in cell membranes and cellular disruption.

  6. Alkali BurnsStrong alkalis raise the PH of tissues and cause saponification of fatty acids in cell membranes and cellular disruption.

  7. Alkali BurnsOnce the epithelium is damaged , alkali solutions readily penetrate the corneal stroma and they rapidly destroy the collagen fibers.

  8. Strong alkaline may also penetrate into the anterior chamber and produce tissue damage and intense inflammation.

  9. The limbus contains the putative corneal epithelial stem cells , when these are damaged, the denuded surface of the cornea is often resurfaced by neighboring conjunctival epithelium and causes conjunctivalization of the cornea and vascularization, inflammation and persistent and recurrent epithelial defeats. Alkali Burns

  10. Intraocular chemical penetration usually causes cataract and glucoma. Alkali Burns

  11. In the most severe cases, phthisisof the globe may occur. Alkali Burns

  12. Classification of Severity “Hughes classification”

  13. Hughes classification Modified by Ballen & Roper-Hall

  14. Acids denature and percipitate proteins in tissues they contact. Acid Burns

  15. Acidic solutions tend to cause less severe tissue damage than alkaine solutions.Because of the buffering capacity of tissues, as well as the barrier to penetration formed by percipitated protein. Acid Burns

  16. The most important step is immediate and copius irrigation of the ocular surface with water or normal saline solution. Topical anesthetic should be instilled. Therapy of chemical injuries to the eye Irrigate - Irrigate - Irrigate

  17. It should be continued until the PH of the conjunctival sac normalizes.The conjunctival PH can be checked easily with a urinary PH strip. Therapy

  18. Severe chemical injuries can be approched by performing a paracentesis of anterior chamber removing 0.1- 0.2ml of aqueous humor and reforming the chamber with B.S.S to normalize the anterior chamber PH. Therapy

  19. the next phase of therapy should be decreasing inflammation , controling IOP, limiting keratolysis , and promoting reepithelialization of the cornea. Therapy

  20. Corticosteroids are excellent inhibitors of PMN function, and intensive topical steroids administration is recommended for the first 2 weeks following chemical injuries. Therapy

  21. The steroid should be markedly reduced after 2 weeks , because of the ability of steroids to inhibit wound healing and potentiate infection. Therapy

  22. A deficiency of calcium in the plasma membrane of the PMNs inhibits their ability to degranulate , and both tetracycline and citric acid are potent chelators of extracellular calcium. Therefore , oral tetracycline has theroretical benefit for inhibiting PMN-induced collagenolysis. Therapy

  23. Ascorbic acid is believed to promote collagen synthesis in the alkali-burned eye because ascorbic acid is required as a cofactor for this synthesis. Therapy

  24. It is recommended patient receive 2 grams of oral ascorbic acid (vitc) per day. Therapy

  25. A bandage contact lens or tarsorrhaphy may be beneficial. For epithelial healing

  26. A bandage contact lens or tarsorrhaphy may be beneficial for epithelial healing

  27. From uninvolved fellow eyes of patients limbal stem cell transplantation may be performed as soon as 2 weeks after injury if no signs of corneal epithelialization have appeared by that time. Limbal transplants

  28. COMPLICATIONS • Non-healing epith defect/ conjuctivalization/ melting (stem) • Corneal opacities • Cataract • Glaucoma/ phthisis • Dry eye • Lid malposition/ symblepharon/ trichiasis: more scarring

  29. Prevent Injuries Before They Happen • Many eye injuries can be prevented. • A majority of workplace eye injuries happen to workers who were not wearing adequate eye protection.

  30. ضمن عرض پوزش بدلیل حجم بالای LECTUER ادامه اسلایدها امکان پذیر نمیباشد در صورت نیاز به ادامه لطفا به واحد سمعی و بصری مرکز آموزشی درمانی فیض مراجعه و یا با شماره تلفن 03114476010 داخلی 392تماس حاصل نمائید با تشکر

More Related