Caustic keratoconjunctivitis: Difference between revisions
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==Treatment== | ==Treatment== | ||
#Topical anesthesia (e.g. tetracaine) | #Topical anesthesia (e.g. tetracaine) | ||
# Copious irrigation in 15min intervals followed by pH check | #Copious irrigation in 15min intervals followed by pH check | ||
##LR, NS, or 3% saline works best | ##LR, NS, or 3% saline works best | ||
##Treat until pH is 7.5-8.0 (check with pH strip) | ##Treat until pH is 7.5-8.0 (check with pH strip) | ||
###Avoid testing pH of the irrigation fluid (wait few min before checking ocular fluid) | ###Avoid testing pH of the irrigation fluid (wait few min before checking ocular fluid) | ||
## | ##Alkali exposure requires minimum of 4L over 40min | ||
# Check IOP | #Check IOP | ||
# Consider cycloplegic (e.g. atropine) | #Consider cycloplegic (e.g. atropine) | ||
#Severe exposures may require anterior chamber irrigation | #Severe exposures may require anterior chamber irrigation | ||
==Disposition== | ==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) | |||
==Prognosis== | ==Prognosis== | ||
Revision as of 03:40, 20 September 2011
Background
- Chemical burn to eye
- Alkali injuries are more severe than acidic injuries
Treatment
- Topical anesthesia (e.g. tetracaine)
- Copious irrigation in 15min intervals followed by pH check
- LR, NS, or 3% saline works best
- Treat until pH is 7.5-8.0 (check with pH strip)
- Avoid testing pH of the irrigation fluid (wait few min before checking ocular fluid)
- Alkali exposure requires minimum of 4L over 40min
- Check IOP
- Consider cycloplegic (e.g. atropine)
- Severe exposures may require anterior chamber irrigation
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)
Prognosis
- After irrigation perform complete eye exam
- Prognosis determined by extent of injury at limbus and area/depth of injury to cornea