Chemical eye trauma can occur from exposure to strong acids or alkalis and represents 11.5-22% of ocular injuries. Acids like sulfuric acid and hydrochloric acid, as well as alkalis like potassium hydroxide and sodium hydroxide, can cause chemical burns to the eye depending on the concentration, duration of exposure, and type of chemical. Clinical signs include lid edema, corneal scarring, uveitis, and glaucoma. Treatment involves immediate irrigation of the eye, antibiotic eye drops, atropine, steroid drops to reduce inflammation, and surgery for complications like symblepharon or glaucoma. Proper first aid through irrigation can help minimize tissue damage from chemical burns.

1. Chemical Eye
Trauma
By:
Dr. Amr Mounir
Elham Mahmoud Ahmed

2. Chemical
Eye
Trauma

3. Epidemiology
Chemical injuries to the eye represent about 11,5-
22%of ocular trauma,more in young males,and at
work and homes
Causes:
Duo to exposure to chemicals as acid,alkali ,gases.

4. Types
Strong acid
Sulphoric acid in car battery.
Hydrochloric acid in swimming pool.
Strong alkali
Potassium hydroxide in caustic potash.
Sodium hydroxide in France cleaner.
Other chemicals
Lime, Aniline dye,iodine.

5. The effect depends on:-
*Concentration
*Duration:-
interval between chemical trauma&1st aid
*Pathogenesis:-
it deffers according to the type as:
1-Alkali agents are lipophilic so it penetrate tissues by
saponifing the fatty acids of cell membrans and causing
pentration to the corneal stroma.
2-Acide agents coagulates and participate protiens at
the epithelium forming a physical barrier with less
penetrating effect.

6. Clinical picture
*Symptoms :-
Pain, lacrimation, blepharospasm,photophobia and
drop of vision.

7. Signs
1-Lid
Edema
Triciasis
Corneal ulcer
Cicatricial ectropion ,
Entropion, Lagophthalmos
2-Ocular surface
Dry eye
Corneal scaring,opacity,corneal melt
Symblepharon
Anterior uveitis,iridocyclitis,atrophia bulbi
Conjunctival ulcer,injection,chemosis,pseudopterygium
3-Elevated IOP
Secondary glucoma

12. Treatment
1-First Aid ttt
Immediate irrigation of the eye with water or
physiologic saline for 30 minutes then removal of
partcle and deprdment of necrotic tissue.
A-If the nature of the chemical substance is known :
wash the eye with proper antidote as :
-acids, NaHCO3 3%
-alkali,Boric acid lotion 4%
-iodine, starch solution or milk
-Aniline,Alcohol 10%then glycerin 10%
-Lime,use EDTA 0,1% but water not used
B-If the nature of the chemical substance is unknown:
wash the eye with either,-Tap water -Milk

13. 2-Local treatment
-Antibiotic: tetracycline
-Atropine : for corneal ulceration&iritis
-Steroid :to decrease inflammation,corneal edema,
vascularization,scaring (1st7days )
3-ttt of complication
A -Prevention of symblepharon:
*Glass rod coated with antibiotic ointment
*Cortisone ointment
*Contact shell
*Soft CL
*Limbal stem cell transplantation,help epitheliazation
*AMG,supress fibrosis

14. B-2ry glaucoma
*Diamox
*Trabeculectomy in late cases
C-Lagophthalmos ,
D-Corneal opacity:
*Keratoplasty
E-Dry eye treatment
F-Surgical ttt ot trichiasis & lid

15. Thank you