Ocular Burns Clinical Presentation

  • Author: Cheri N M Weaver, MD; Chief Editor: Robert E O'Connor, MD, MPH   more...
 
Updated: Oct 27, 2011
 

History

Radiant energy burns

Thermal injuries most often result from direct contact with a hot object (eg, curling iron, cigarette). Although these burns can affect a large ocular surface area, they are usually superficial. Patients with superficial burns often complain of symptoms similar to a corneal abrasion. Common complaints include tearing, photophobia, or a foreign body sensation.

A heightened index of suspicion may be required in the case of burns from fire exposure, in that ocular burns might be overlooked in the setting of larger body burns. Burns to the cornea may occur with sparing of the eyelids because individuals may keep their eyes open as they try to escape a fire.

Patients with ultraviolet (UV) burns usually have an obvious history, although it may not be readily apparent to the patient. The most common form of radiation burn is due to unprotected welding. Patients with so-called arc eye presents several hours after exposure with painful, weeping eyes. Also common is a history of excessive exposure to sunlight (as with snow blindness or prolonged or frequent use of tanning booths).

Chemical burns

Chemical injuries usually result from a substance being sprayed or splashed in the face.[10] Alkali injuries occur more frequently than acid burns and are likely more detrimental.

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Physical Examination

In the initial physical examination, assess for other potential life-threatening injuries. The initial physical examination of the eye may be limited to determination of pH and evaluation of visual acuity.

After copious irrigation, a full ophthalmologic examination is required. This may reveal tearing, conjunctival injection, scleral injection, scleral blanching, corneal defects, corneal opacification, uveitis, glaucoma, or globe perforation. Decreased visual acuity may be noted. Fluorescein evaluation is needed to determine the extent of the injury. With UV injuries, a punctate keratitis may be noted. Lid eversion is necessary to evaluate for the presence of retained solid substances.

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Contributor Information and Disclosures
Author

Cheri N M Weaver, MD  Resident Physician, Department of Emergency Medicine, Beth Israel Deaconess Medical Center

Disclosure: Nothing to disclose.

Coauthor(s)

Carlo L Rosen, MD  Associate Professor of Medicine, Harvard Medical School; Program Director, Vice Chair for Education, Department of Emergency Medicine, Beth Israel Deaconess Medical Center/Harvard Affiliated Emergency Medicine Residency program

Carlo L Rosen, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Debra Slapper, MD  Consulting Staff, Department of Emergency Medicine, St Anthony's Hospital

Debra Slapper, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Chief Editor

Robert E O'Connor, MD, MPH  Professor and Chair, Department of Emergency Medicine, University of Virginia Health System

Robert E O'Connor, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physician Executives, American Heart Association, American Medical Association, Medical Society of Delaware, National Association of EMS Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

References

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

  2. Corazza M, Trincone S, Virgili A. Effects of airbag deployment: lesions, epidemiology, and management. Am J Clin Dermatol. 2004;5(5):295-300. [Medline].

  3. Javadi MA, Yazdani S, Sajjadi H, et al. Chronic and delayed-onset mustard gas keratitis: report of 48 patients and review of literature. Ophthalmology. Apr 2005;112(4):617-25. [Medline].

  4. Merle H, Gerard M, Schrage N. [Ocular burns]. J Fr Ophtalmol. Sep 2008;31(7):723-34. [Medline].

  5. 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].

  6. Christoffersen T, Olsen EG. Injury to the cornea due to fish bile. Scand J Work Environ Health. Oct 1993;19(5):358-9. [Medline].

  7. Stern JD, Goldfarb IW, Slater H. Ophthalmological complications as a manifestation of burn injury. Burns. Mar 1996;22(2):135-6. [Medline].

  8. Kuckelkorn R, Schrage N, Keller G, Redbrake C. Emergency treatment of chemical and thermal eye burns. Acta Ophthalmol Scand. Feb 2002;80(1):4-10. [Medline].

  9. Peate WF. Work-related eye injuries and illnesses. Am Fam Physician. Apr 1 2007;75(7):1017-22. [Medline].

  10. Das S, Chohan A, Snibson GR, Taylor HR. Capsicum spray injury of the eye. Int Ophthalmol. Aug-Oct 2005;26(4-5):171-3. [Medline].

  11. Ikeda N, Hayasaka S, Hayasaka Y, Watanabe K. Alkali burns of the eye: effect of immediate copious irrigation with tap water on their severity. Ophthalmologica. 2006;220(4):225-8. [Medline].

  12. Malhotra R, Sheikh I, Dheansa B. The management of eyelid burns. Surv Ophthalmol. May-Jun 2009;54(3):356-71. [Medline].

  13. Prabhasawat P, Tesavibul N, Prakairungthong N, Booranapong W. Efficacy of amniotic membrane patching for acute chemical and thermal ocular burns. J Med Assoc Thai. Feb 2007;90(2):319-26. [Medline].

  14. Tejwani S, Kolari RS, Sangwan VS, Rao GN. Role of amniotic membrane graft for ocular chemical and thermal injuries. Cornea. Jan 2007;26(1):21-6. [Medline].

  15. Liang L, Li W, Ling S, Sheha H, Qiu W, Li C, et al. Amniotic membrane extraction solution for ocular chemical burns. Clin Experiment Ophthalmol. Dec 2009;37(9):855-63. [Medline].

  16. Schrader S, Notara M, Beaconsfield M, Tuft SJ, Daniels JT, Geerling G. Tissue engineering for conjunctival reconstruction: established methods and future outlooks. Curr Eye Res. Nov 2009;34(11):913-24. [Medline].

  17. Marquez De Aracena Del Cid R, Montero De Espinosa Escoriaza I. Subconjunctival application of regenerative factor-rich plasma for the treatment of ocular alkali burns. Eur J Ophthalmol. Nov-Dec 2009;19(6):909-15. [Medline].

 
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