How does acid burn eye handle?
summary
Acid ocular chemical burn is one of the common and difficult ocular injuries. Aseptic corneal ulceration, perforation, eyeball adhesion and secondary glaucoma are the common causes of ocular disability. Let's share my experience with you.
How does acid burn eye handle?
As soon as possible and sufficient flushing, to wash away the residual acid or even acid particles on the surface of the eyes. We use a self-made continuous flushing device, which depends on the time of injury and the strength of acid. The flushing time is 1-2 hours.
Resection of necrotic tissue: for moderate and severe acid burns, the conjunctiva is cut in the quadrant with edema, and the conjunctiva with edema, ischemia or near necrosis is separated and excised from the sclera with iris separator, so as to discharge the toxic liquid under the conjunctiva, reduce the tissue pressure, and improve the circulation and nutritional status. Severe anterior segment burns are accompanied by ischemic necrosis of cornea, limbus and adjacent bulbar conjunctiva. The necrotic conjunctiva and subconjunctival tissue should be removed to avoid further damage of toxic substances released.
Application of corticosteroids: We used prednisone 30mg / D in the first week after acid burn to reduce acute tissue damage caused by inflammatory exudation and leukocyte infiltration, stopped using prednisone in 2-3 weeks to prevent corneal ulcer, and applied prednisone again in 4-5 weeks to prevent tissue organization.
matters needing attention
After emergency treatment, corneal epithelium of 194 eyes healed in the next day and 16 eyes in 2-3 days. Conjunctival congestion disappeared and cornea was transparent in 1-2 weeks. There was no significant difference in visual acuity between before and after injury (P < 0.01). The cure rate was 100%. The irritation symptoms of moderate burn patients disappeared in 1-2 weeks, but 95% of the patients left some sequelae, such as conjunctival sac narrowing and corneal cloudiness, and their vision also decreased in varying degrees, which was related to the degree of burn. Severe burn patients have severe visual impairment, even only light perception or blindness, and need blepharoplasty to correct the complications such as ectropion and eyelid defect.
