injuries and poisoning
Burns to the Eye
Treatment of Burns to the Eye
Immediate flushing of the eye with water Continued flushing of the eye with saline by medical personnel A chemical burn of the eye is treated immediately, even before medical personnel arrive. The eye is opened and flushed (irrigated) with water or saline. When burns are caused by strong acids or alkali or other severely caustic substances, the eye should be irrigated continuously for at least 30 minutes or until the pH (a measure of the acidity or alkalinity) of the eye is normal. Irrigation can be continued where it began, in an ambulance, or in an emergency department. Because pain may make it difficult for the person to keep the injured eye open, another person may have to hold the eyelid open while the eye is irrigated. A doctor or other health care practitioner can instill an anesthetic drop in the eye to make it much easier to keep the injured eye open. In an emergency department, doctors often use special irrigating devices. A chemical burn of the eye should be flushed with water immediately, and flushing should continue at least until medical personnel arrive. After irrigation, the doctor examines the surface of the eye and the inside of the eyelid and removes any substance still embedded in the tissue. The inside of the eyelid is also swabbed to remove any tiny particles that may not be visible. A doctor may instill a drop of a drug (such ascyclopentolateor homatropine) that dilates the pupil, relaxing the muscles of the colored part of the eye (iris) and preventing them from having painful spasms. Topical antibiotics (drops or ointment) are used to lubricate the eye and prevent infection. Corticosteroid drops (such asprednisolone) may also be given by an ophthalmologist for a limited period of time. Although anesthetic eye drops relieve pain, they may also slow healing and are usually not given after the initial irrigation. Pain can be treated withacetaminophenor, if severe,acetaminophenwithoxycodone. If the cornea is burned, an antibiotic ointment is put in the eye. Severe burns need to be treated by an ophthalmologist (a medical doctor who specializes in the evaluation and treatment—surgical and nonsurgical—of eye disorders) within 24 hours to preserve vision and prevent serious complications, such as damage to the cornea and iris, perforation of the eye, and deformities of the eyelid. In more severe burns, other topical and/or oral drugs such as vitamin C may also be used. Severe burns require frequent eye examinations. Some chemical burns are so severe that surgery is required and even with the best treatment the eye can become blind or visually impaired. Eyelid burns are treated like other skin burns. Doctors clean eyelid burns and then apply an eye antibiotic to prevent infection. Burns of the conjunctiva or cornea may be painful, so people may need to take analgesics. Doctors may also give cycloplegic eye drops (such ascyclopentolateor homatropine) to prevent painful spasm of the muscles that constrict the pupil, as well as an antibiotic eye ointment to prevent infection. 