Eye burn - Symptoms, Causes and Treatments

Definition

An eye burn is an injury whose origin can be chemical or thermal, more rarely electrical.

Classification

We distinguish:

chemical burns are due to the projection onto the anterior surface of the eyeball (between the two eyelids) of caustic products (bases), or acids. The seriousness of chemical injuries compared to heat contact burns, lies in the fact that acids constitute a complex substance by mixing the proteins of the surface of the eye, and the projected acid for example. This type of burn requires immediate and abundant washing, with a large quantity of tap water (by default), but preferably with physiological serum, rather lukewarm, until the toxic liquid is eliminated.
Ultraviolet burns (arc flash, snow blindness) occur quite frequently and are benign.
The same applies to domestic burns (occurring, for example, when opening a bottle of bleach or drain unblocking products, among others). In industrial environments where certain dangerous products are used, caustic splashes (bases) are particularly harmful. Indeed, alkaline (basic) substances cause a chemical reaction with the fatty acids (lipid constituent: fat) of the eye tissue. This chemical reaction is called saponification. This leads to the destruction of cell membranes, thus promoting the rapid entry of the caustic product into the tissues. This is particularly the case for ammonia, which sometimes ends up penetrating the anterior chamber of the eyeball. Some burns (firefighters) have a negative outcome because they affect the eyelids and the lacrimal system (the apparatus used to produce tears).
accidental cigarette burns cause damage to the layer of cells covering the eyeball (localized epithelial damage), sometimes deeper, resulting in what specialists call a superficial stromal lesion. Healing is relatively rapid, leaving little or no after-effects.
La burning eyelids is most often of thermal origin (contact with fire or heat). This type of burn is comparable to burns in general with degrees of severity (first, second, third degree). Most often, it involves the projection of an incandescent foreign body. The presence of a film made up of tears (tear film) somewhat reduces the intensity of the burn.

Symptoms

Symptoms of an eye burn include:

Un tearing translates an attack on the conjunctiva (thin membrane protecting the eyeball).
A necrosis corresponds to the destruction of the tissue made up of cells lining the surface of the eye, around the cornea (layer of cells located immediately under the conjunctiva protecting the pupil and the iris).
A clouding and total sensitivity of the cornea, reflect a burning sensation and a reduction in visual acuity.
The presence of adhesions that prevent the closure of the slot palpebral (space located between the two eyelids), corresponds to the symblepharon, resulting from necrosis of the conjunctival cul-de-sacs. The evolution of the symblepharon is sometimes done towards the appearance of a ulcer (more or less deep wound) of the cornea.

Medical exam

Physical examination

The depth of the burn is known after examination by an ophthalmology specialist (slit lamp).

Treatment

Treatments for an eye burn include:

Thorough and repeated washing, keeping the eyelids well apart, is essential. The doctor will use, if necessary, spreaders, and will practice instillation of anesthetic eye drops (Novesine, Cebesine, available in ophtadoses disposable). This washing must also be repeated, after removing any foreign bodies.
It is also necessary to note the name of the product(s) involved, and the manner in which the product was projected (steam, direct projection). Sometimes it is necessary to use strips to highlight the pH (acidity) of tears.
Foreign bodies must be removed, as their presence may promote the spread of the product.
Injection of drugs with vasodilatory properties (which increase the caliber of the vessels) below the conjunctiva is sometimes necessary depending on the cause of the burn.
antibiotics will often be prescribed to prevent eye infections.
Repeated and close monitoring is necessary in a specialized environment.
It is sometimes useful, to evacuate the toxic substance which has accumulated in the aqueous humor, to puncture the anterior chamber of the eye under an operating microscope. Aqueous humor is the liquid of the eye, of a physiological nature (salt water whose concentration is equal to that of blood) located in its anterior chamber, and serving to regulate the pressure inside it, as well as to nourish its structures, by allowing the elimination of waste. The aqueous humor is located between the cornea and the lens.
Ophthalmic surgery is performed under local (or sometimes general) anesthesia. Its purpose is to remove the adhesion (the band) and prevent it from reformationTo do this, the surgeon places a tool between the two conjunctivas, consisting of a sort of plastic shell with a hole at the pupil level, thus allowing light to penetrate. the eyeThis shell is inserted under the eyelids, and prevents the different layers constituting the conjunctiva from sticking together.
Prevention of symblétpharon, and the destruction of adhesions that may form, require the ophthalmologist to pass a glass rod coated with an antiseptic ointment (to fight germs) between the conjunctiva and the inner surface of the eyelid, until healing. Some medical teams use, to treat the symblétpharon, a drug containing dimethicone. This product is also used when there are burns of the eye, and eyelids. The use of this medication should be done with caution, especially in cases of prolonged ulceration of the cornea.
In some patients, it is necessary to perform a graft of healthy conjunctiva, or of oral mucosa (layer of cells covering the inside of the mouth), to reconstruct a revascularization (new ships) of the area injured by the burn.
The abnormal presence of a pillowcase (also called leukoma) corneal, corresponding to a spot on the cornea, sometimes requires a transplant if vision problems persist.

Evolution

The severity and depth of eye burns depend on their cause (chemical or thermal).

A product used by ophthalmologists (fluorescein), instilled into the connective tissue, allows the damaged (de-epithelialized) areas to be highlighted upon inspection.

The Roper-Hall classification is most often used in ophthalmology to quickly assess the severity of a chemical burn and to provide a prognosis.