Chemical Burn M.R Manaviat MD The most important ocular Emergency.

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Presentation transcript:

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  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.

Treatment  1-Emergency.  2-Medical.  3-Surgical.

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

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

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

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.