The ocular surface chemical burns
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s fThe document summarizes the effects of chemical burns on the ocular surface and the different treatment phases. Basic substances penetrate the eye more rapidly than acids, lysing cell membranes and triggering inflammation. Acids cause protein coagulation in the epithelium. Factors like pH, temperature, and concentration determine damage. The reparative phases are immediate, acute, early, and late. Early signs include epithelial defects and conjunctival inflammation. The acute phase involves reestablishing the corneal epithelium and potential glaucoma. Later phases involve chronic inflammation, scarring, and secondary complications like glaucoma. Emergency therapy focuses on irrigation, lubricants, and antibiotics. Surgical management includes debridement, amniotic membrane transplantation
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Dry eye
This document provides an overview of dry eye disease. It defines dry eye as a multifactorial disease resulting from tear deficiency or excess evaporation, causing symptoms like eye discomfort. Diagnostic tests evaluate tear secretion, stability, and damage to the ocular surface. Clinical features include irritation, redness, blurred vision, and staining of the cornea or conjunctiva. Dry eye exists on a spectrum of severity and has many predisposing factors like age, gender, medication use, contact lens wear, surgery, and autoimmune diseases.
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The document discusses various conditions of the eyelids and surrounding structures including:
1) Contusion of the upper eyelid following blunt trauma.
2) Chalazion, which is a focal chronic inflammation of a meibomian gland that may require incision and curettage when chronic.
3) Multiple small chalazia, acute dacryocystitis pointing on the skin side, entropion of the lower eyelid with trichiasis, and rubbing lashes of the upper eyelid causing discomfort.
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Ophthalmology is the branch of medicine dealing with the eyes and vision. It includes diagnosis and treatment of eye disorders. Ophthalmologists are medical doctors who provide full eye care including exams, prescribing corrective lenses, diagnosing and treating diseases, and performing eye surgery. Optometrists provide similar services but cannot perform surgery. Opticians fill prescriptions for eyeglasses. Blepharitis is a common inflammation of the eyelids that occurs when oil glands near the eyelashes become clogged. It can cause red, irritated eyes and crusty eyelashes. Treatment focuses on eyelid scrubs and warm compresses to remove bacteria and debris from the eyelids.
Dry eye
This document discusses dry eye, including its causes, diagnostic tests, and treatment options. It provides an overview of dry eye as one of the most common conditions seen by eye practitioners. Key points include:
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- Common diagnostic tests include tear break-up time, Schirmer test, and staining of the ocular surface with dyes. Newer tests measure tear osmolarity.
- Treatment focuses on managing symptoms, treating underlying causes, and stabilizing the tear film through lubricating eye drops, ointments, or gels. Preservative
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etiology:-Chemical injuries occur as a result of acid, alkali, or neutral agents.Alkalis being responsible for 60%.
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Surgical treatment
Dry eye disease
Dry eye is a common disease caused by insufficient tear production or increased tear evaporation. It affects 10-15% of the population and prevalence is higher in females and older individuals. The tear film consists of an outer lipid layer, middle aqueous layer, and inner mucus layer which together form a smooth optical surface and nourish the cornea. Dry eye is diagnosed based on symptoms, tear film breakup time, Schirmer's test, and ocular surface staining. Treatment involves artificial tears, punctal plugs, anti-inflammatories, and managing underlying conditions. Advanced cases may require punctal occlusion, contact lenses, or autologous serum tears.
Chemical injuries of the eye
This document discusses chemical injuries to the eye. It begins with an introduction and overview of the epidemiology, etiology, pathogenesis, classification, clinical course, features, and management of such injuries. It notes that alkali injuries are more common and can be more deleterious. The pathogenesis and healing process differs for acid versus alkali injuries. Classification systems include Hughes, Roper-Hall, and Dua's, which predicts outcomes. Management involves immediate irrigation, acute medical treatment with steroids and antibiotics, and potential surgical interventions like debridement or amniotic membrane transplantation. Long-term goals are promoting healing, controlling inflammation and preventing complications.
CHEMICAL INJURIES EYE
1. Chemical injuries to the eye can result from exposure to acids or alkalis and are a true ophthalmic emergency. 2. The severity depends on factors like type, concentration, and duration of exposure and can lead to significant vision loss. 3. Management involves immediate irrigation, controlling inflammation, promoting healing, and preventing complications. Treatment may include debridement, amniotic membrane transplantation, and long-term use of medications.
Chemical injury
This document discusses chemical eye injuries, which are ophthalmic emergencies requiring immediate treatment to prevent vision loss. It describes the types of chemicals that can cause eye injuries, including acids, alkalis, and neutrals, and how their pH levels affect injury severity. Alkalis like ammonia and sodium hydroxide are particularly dangerous as they penetrate rapidly. The document also outlines classifications of ocular burns and recommends initial management steps like irrigation before discussing longer-term treatment approaches.
Allergic conjunctivitis
This document discusses various types of allergic conjunctivitis. Acute allergic conjunctivitis is commonly caused by environmental allergens like pollen and presents with itching, watering and chemosis. Vernal keratoconjunctivitis typically affects boys and causes intense itching and thick discharge, with papillae on the conjunctiva and corneal erosions. Atopic keratoconjunctivitis is a chronic form associated with atopic dermatitis and causes severe eyelid and conjunctival involvement. Giant papillary conjunctivitis is induced by mechanical stimuli like contact lenses. Seasonal allergic conjunctivitis occurs in spring/summer while perennial type occurs year-round.
CHEMICAL_INJURY presentation dhir hospital.pptx
1) Chemical injury to the eye is a true ocular emergency that requires immediate irrigation to remove the chemical. Common chemicals involved are acids and alkalis.
2) Examination involves assessing the extent of injury to the cornea, conjunctiva and limbus. Classification systems help determine prognosis.
3) Management of acute injury focuses on copious irrigation, topical steroids, antibiotics and cycloplegics. Surgery may include debridement, amniotic membrane grafting or tenonplasty.
4) Chronic management addresses complications like symblepharon, persistent epithelial defects and limbal stem cell deficiency. Transplants and keratoprostheses can help stabilize the ocular surface long
Chemical burns
This document discusses chemical burns to the eye. It notes that both thermal and chemical burns can cause blindness. Common causes of chemical burns are cleaning products, fertilizers, cement, fireworks, battery acid, and bleach. Alkaline agents like these cause more damage than acids as they penetrate cell membranes and disrupt collagen. A classification system grades injuries based on extent of limbal ischemia and corneal haze. Treatment involves immediate and copious irrigation, controlling inflammation with steroids, promoting healing with artificial tears and ascorbate, and managing intraocular pressure. The goal is to remove the chemical, promote healing, prevent infection, and control inflammation.
CHEMICAL INJURIES OF EYEnew.p dr manuptx
This document discusses chemical eye injuries, including common causes, pathophysiology, clinical presentation, grading, complications, and management. Some key points:
- Chemical exposures can cause ocular trauma ranging from mild irritation to severe damage and vision loss. Common causes include household cleaners, industrial chemicals, and agricultural chemicals.
- Injuries are classified based on extent of corneal and limbal damage. Grade 1-2 injuries often recover with medical treatment while grade 3-4 generally require surgery in addition to medical management.
- Immediate irrigation is critical. Examination evaluates clarity, ischemia, IOP, and debridement may be needed. Treatment goals are removing the chemical, promoting healing, controlling inflammation,
Ocular chemical injury
chemical injury to eye by alkali, acids and irritants.
pathophysiology and management.
recent advances in management.
ITS A TRUE EMERGENCY IN OPHTHALMOLOGY
Latest Advances in Dry Eye Management.pptx
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Dry eye management
Dry eye management involves evaluating a patient's history, symptoms, and signs of dry eye through examination and tests. Treatment aims to relieve discomfort, maintain a smooth optical surface, and prevent damage. It includes lifestyle modifications, medical treatments like tear substitutes, anti-inflammatory agents, and procedures like punctal occlusion. Regular follow up and counseling are important for monitoring response and providing support.
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The ocular surface chemical burns
- 1. The Ocular Surface Chemical Burns
- 2. Basic substances and acidic chemicals Basic substances are lipophilic and penetrate the eye more rapidly compared to acidic chemicals, saponification of fatty acids in cell membranes lysis of cell membranes liberates mediators of chemotaxis and inflammation such as prostaglandins, leukotrienes, and interleukins leading to an immediate immunological response Acids cause protein coagulation in the epithelium, coagulation necrosis → hydrofluoric acid is an exception among acid since it can rapidly pass through cell membranes • Factors determining the amount and type of tissue damage : pH, temperature, amount, impact force, concentration, dissociation coefficient (osmolarity)
- 3. Reparative phases : immediate, acute, early, late • Immediate phase : from the moment a chemical agent comes in contact with the ocular surface Early signs include corneal and conjunctival epithelial defects, chemosis, conjunctival inflammation, limbal ischemia, corneal cloudiness, sterile ulceration, edema, perforation • Acute phase : first seven days , reestablishing corneal epithelium , usually a rise in the IOP inflammatory debris trapping within the meshwork Shrinkage and contraction of the cornea and sclera may lead to fibrotic damage to the trabecular meshwork
- 4. • Early phase : 8–20 days, chronic inflammatory response, stromal repair, and scarring A persistent epithelial defect can lead to corneal ulceration during this stage • Late phase : three weeks after a chemical injury breakdown products of the damaged ocular tissue that act as new antigens, causing invasion of leukocytes and macrophages Treatment-resistant secondary glaucoma, Lagophthalmos, symblepharon, cicatricial entropion and ectropion, trichiasis, contracture of the fornices, xerophthalmia, ankyloblepharon uveitis, cataract Cause of dryness : Conjunctival inflammation and loss of goblet cells
- 5. Symbelpharon
- 7. Limbal ischemia in the inferonasal quadrant 8 days after alkali burn. Patient subsequently underwent tenonplasty and conjunctival advancement to cover the defect
- 8. Initial examination • foreign bodies • Epiphora, blepharospasm, periorbital edema and erythema, deepithelialized skin • loss of eyelashes and eyebrows • degree of limbal, corneal, and conjunctival involvement
- 11. associated with prognosis degree of limbal, corneal, and conjunctival involvement
- 12. Emergency Therapy • extensive irrigation continue rinsing the eye for no less than 10 minutes until pH normalizes to 7 • Preservative free tear substitutes and lubricating ointment • systemic ascorbic acid • Topical corticosteroids should not be used beyond 10 to 14 days • Cycloplegic drops blunt the pain from iris-ciliary body spasm • bandage contact lenses may be considered for delayed epithelial healing
- 13. • Treatment of High Intraocular Pressure oral aqueous suppression is generally preferred over topical agents Medical treatment and surgical treatment • Systemic tetracycline may also boost healing of persistent corneal epithelial defects
- 14. Surgical Management • early surgery maintain the globe and promote reepithelialization initial debridement of the necrotic material and continues with amniotic membrane transplantation and tectonic grafting if necessary • Late surgical interventions, on the other hand, are aimed at restoring the normal ocular surface anatomy and visual function • Amniotic Membrane Transplantation • Tenonplasty • Limbal Stem Cell Transplantation