Definition: Chemical eye burns are most commonly from household, industrial and criminal origin – with various acids and bases.
Acid burns result in necrosis (killing) of the affected tissues. In the first hours after burning, the conjunctiva is swollen, greyish and cloudy, and the cornea is also cloudy. Necrosis is usually confined to the superficial layers and, once removed, the long epithelial layers can be completely restored. Rarely, after corneal burns, corneal obstruction or conjunctival adhesions remain.
The bases also cause necrosis, but it is deeper and often the necrosis process affects almost all eye structures and complete loss of vision or the whole eye. When burned with concentrated bases, the conjunctiva is immediately bled and the cornea becomes white as porcelain. Tissue breakdown triggers a local autoallergic reaction.
The timing and quality of first aid after burns (especially with basics) is paramount. Immediately after burning, wash the eye with warm water with the eyelids turned. The jet should not fall on the cornea, just pour it. After washing, neutralization of the affected chemical is carried out. In the case of acid burns, base solutions are applied, and in case of base burns, an acid solution is applied.
Atropine, ointments, vitamin A, sulfamides and antibiotics are also topically (locally) used to prevent infection.
In the case of chemical combustion, no eye bandage should be placed as it prevents the chemical from being removed by reflexively enlarged tear gas. For very severe burns, when the conjunctiva is necrotic and short, surgical treatment is applied and the necrotic tissue is removed. In severe burns of the cornea with perforated or threatening perforation, partial or complete operative plastic is also taken. However, the postoperative results in a high percentage are unsatisfactory.