Chemical burns of the ocular surface

“Fortunately, the majority of chemical burns of the ocular surface are mild,” said Dr Harminder Dua MD, PhD  at the EuCornea Congress.

But for the rest, prompt correct treatment can make a huge difference.

“Copious irrigation is a given, but make sure to use an eyelid speculum and, importantly, topical anaesthesia,” said Prof Dua.

Re-measuring the pH an hour or so after the end of irrigation is also crucial, since alkali can continue to ooze out of tissues, despite a normal pH immediately after irrigation.

Prof Dua said to avoid using 10 per cent phenylephrine, due to its vasoconstrictive effects, which can contribute to ischaemia. For intraocular pressure control, “substituting oral diamox for a topical agent removes at least one topical irritant from the treatment.”

Further, “alpha adrenergic agonists may not work, since collagen shrinkage affects uveosclera.