Caustic keratoconjunctivitis: Difference between revisions
| Line 9: | Line 9: | ||
# Check IOP | # Check IOP | ||
# Consider cycloplegic (e.g. atropine) | # Consider cycloplegic (e.g. atropine) | ||
*Alkali injuries are more severe than acidic injuries | |||
*Treatment | |||
**Copious irrigation in 15min intervals followed by pH check | |||
**LR, NS, or 3% saline works best | |||
**Treat until pH is 7.5-8.0 | |||
**Severe exposures may require anterior chamber irrigation | |||
**Avoid testing pH of the irrigation fluid (wait few min before checking ocular fluid) | |||
*After irrigation perform complete eye exam | |||
**Prognosis determined by extent of injury at limbus and area/depth of injury to cornea | |||
*Disposition | |||
**Admit all pts w/ corneal haziness or opacity or limbal ischemia (paleness at limbus) | |||
**Discharge w/ 24hr f/u if pt only has corneal epithelial injury (fluorescein uptake) | |||
==See Also== | ==See Also== | ||
Revision as of 18:33, 26 July 2011
Background
Chemical burn to eye
Treatment
- Topical anesthesia (e.g. tetracaine)
- Irrigate!!!
- until pH 7.0 (check with pH strip)
- alkaline exposure requires minimum of 4L over 40min
- Check IOP
- Consider cycloplegic (e.g. atropine)
- Alkali injuries are more severe than acidic injuries
- Treatment
- Copious irrigation in 15min intervals followed by pH check
- LR, NS, or 3% saline works best
- Treat until pH is 7.5-8.0
- Severe exposures may require anterior chamber irrigation
- Avoid testing pH of the irrigation fluid (wait few min before checking ocular fluid)
- After irrigation perform complete eye exam
- Prognosis determined by extent of injury at limbus and area/depth of injury to cornea
- Disposition
- Admit all pts w/ corneal haziness or opacity or limbal ischemia (paleness at limbus)
- Discharge w/ 24hr f/u if pt only has corneal epithelial injury (fluorescein uptake)