Ophthalmologic Approach to Chemical Burns Workup

  • Author: J Bradley Randleman, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Feb 7, 2011
 

Laboratory Studies

  • The pH of the ocular surface should be periodically tested. Irrigation should be continued until the pH reaches neutrality.
  • No other laboratory tests are generally necessary unless other systemic injuries are concurrent.
Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

J Bradley Randleman, MD  Associate Professor, Department of Ophthalmology, Section of Cornea, External Disease and Refractive Surgery, Emory University School of Medicine; Director of Cornea, External Disease and Refractive Surgery Fellowship, Emory University; Physician Member, Section of Ophthalmology, The Emory Clinic

J Bradley Randleman, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Cornea Society, and International Society of Refractive Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Alok S Bansal, MD  Resident Physician, Emory Eye Center

Alok S Bansal, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology, and International Society of Refractive Surgery

Disclosure: Nothing to disclose.

Evan S Loft  MD, Clinical Assistant Professor, Department of Ophthalmology, Emory University

Evan S Loft is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Geoffrey Broocker, FACS, MD  Walthour-DeLaPerriere Professor of Ophthalmology, Department of Ophthalmology, Emory University School of MedicineChief of Service, Ophthalmology, Grady Memorial Hospital

Geoffrey Broocker, FACS, MD is a member of the following medical societies: American College of Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Fernando H Murillo-Lopez, MD  Senior Surgeon, Unidad Privada de Oftalmologia CEMES

Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Christopher J Rapuano, MD  Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director of Refractive Surgery Department, Wills Eye Institute

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology

Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other; Vistakon Honoraria Speaking and teaching; EyeGate Pharma Consulting; Inspire Consulting fee Consulting; Bausch & Lomb Honoraria Speaking and teaching; Bausch & Lomb Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

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  2. Hodge C, Lawless M. Ocular emergencies. Aust Fam Physician. Jul 2008;37(7):506-9. [Medline].

  3. Spector J, Fernandez WG. Chemical, thermal, and biological ocular exposures. Emerg Med Clin North Am. Feb 2008;26(1):125-36, vii. [Medline].

  4. Pfister DA, Pfister RR. Acid injuries of the eye. Fundamentals of Cornea and External Disease. Cornea. Vol 2. 2005:1277-84.

  5. Pfister RR, Pfister DA. Alkali injuries of the eye. In: Fundamentals of Cornea and External Disease. Cornea. Vol 2. 2005:1285-93.

  6. Xiang H, Stallones L, Chen G, Smith GA. Work-related eye injuries treated in hospital emergency departments in the US. Am J Ind Med. Jul 2005;48(1):57-62. [Medline].

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  9. Wagoner MD, Kenyon KR. Chemical injuries of the eye. Clinical Practice. In: Albert, Jakobiec, eds. Principles and Practice of Ophthalmology. Vol 2. 2000:943-59.

  10. Kheirkhah A, Johnson DA, Paranjpe DR, Raju VK, Casas V, Tseng SC. Temporary sutureless amniotic membrane patch for acute alkaline burns. Arch Ophthalmol. Aug 2008;126(8):1059-66. [Medline].

  11. Tandon R, Gupta N, Kalaivani M, et al. Amniotic membrane transplantation as an adjunct to medical therapy in acute ocular burns. Br J Ophthalmol. Feb 2011;95(2):199-204. [Medline].

  12. Brodovsky SC, McCarty CA, Snibson G, et al. Management of alkali burns : an 11-year retrospective review. Ophthalmology. Oct 2000;107(10):1829-35. [Medline].

  13. Kheirkhah A, Johnson DA, Paranjpe DR, Raju VK, Casas V, Tseng SC. Temporary sutureless amniotic membrane patch for acute alkaline burns. Arch Ophthalmol. Aug 2008;126(8):1059-66. [Medline].

  14. Kawashima M, Kawakita T, Satake Y, Higa K, Shimazaki J. Phenotypic study after cultivated limbal epithelial transplantation for limbal stem cell deficiency. Arch Ophthalmol. Oct 2007;125(10):1337-44. [Medline].

  15. Tuft SJ, Shortt AJ. Surgical rehabilitation following severe ocular burns. Eye. Jan 23 2009;[Medline].

  16. Dua HS, King AJ, Joseph A. A new classification of ocular surface burns. Br J Ophthalmol. Nov 2001;85(11):1379-83. [Medline].

 
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Alkali burn. Note the severe conjunctival reaction and stromal opacification blurring iris details inferiorly.
Severe chemical injury with early corneal neovascularization.
Complete cicatrization of the corneal surface following chemical injury.
 
 
 
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