Ocular burns

The University of Witwatersrand has done a study on various eye injuries in the workplace with particular reference to chemical ocular burns and the use of Diphoterine®.

“Chemical or thermal burns need immediate attention and are true emergencies as the damage can be ongoing. Alkalis penetrate faster and deeper than acids but both are very damaging if strong solutions are involved. All require immediate and profuse irrigation then refer ASAP to an ophthalmologist. Tap water can be used but it is better to use local anaesthetic drops then irrigate with a sterile drip solution eg. Ringers or saline. Direct the stream of water away from the unaffected eye or chemical might be irrigated into the normal side. There are better available irrigation solutions like Diphoterine®. Never attempt to neutralise the acid with an alkali and vice versa. Lack of corneal clarity so that iris detail is obscured as well as pallor of the limbal conjunctiva indicating ischaemia are ominous signs and indicate severe damage with a poor prognosis for healing and vision. Referral: ASAP if there is corneal involvement with cloudy iris detail or they look to be severe but initial copious irrigation is the cornerstone.”

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