Chemical eye injury

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Chemical eye injury
Other namesChemical burns to the eye
Chemical burn injury..jpg
An alkali burn to the human cornea can cause ocular surface failure with neovascularisation, opacification and blindness resulting from LESC deficiency.
Specialty Ophthalmology

Chemical eye injury are due to either an acidic or alkali substance getting in the eye. [1] Alkalis are typically worse than acidic burns. [2] Mild burns will produce conjunctivitis while more severe burns may cause the cornea to turn white. [2] Litmus paper is an easy way to rule out the diagnosis by verifying that the pH is within the normal range of 7.0—7.2. [1] Large volumes of irrigation is the treatment of choice and should continue until the pH is 6–8. [2] Local anesthetic eye drops can be used to decrease the pain. [2]

Epidemiology

In the United States, chemical eye injuries most commonly occur among working-age adults. [3] A 2016 analysis of emergency department visits from 2010 to 2013 reported over 36,000 visits annually for chemical burns to the eye, with a median age at presentation of 32 years. [4] By individual year of age, 1- and 2-year-old children have the highest incidence of these injuries, with rates approximately 50% higher than the highest-risk adult group (25 years), and 13 times higher than the rate among 7-year-olds. [4] Further research identified laundry detergent pods as a major source of injury among small children. [5]

Related Research Articles

Conjunctivitis Inflammation of the eye

Conjunctivitis, also known as pink eye, is inflammation of the outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. The affected eye may have increased tears or be "stuck shut" in the morning. Swelling of the white part of the eye may also occur. Itching is more common in cases due to allergies. Conjunctivitis can affect one or both eyes.

Glaucoma Eye disease in which high intraocular pressure damages the optic nerve

Glaucoma is a group of eye diseases that result in damage to the optic nerve and cause vision loss. The most common type is open-angle glaucoma, in which the drainage angle for fluid within the eye remains open, with less common types including closed-angle glaucoma and normal-tension glaucoma. Open-angle glaucoma develops slowly over time and there is no pain. Peripheral vision may begin to decrease, followed by central vision, resulting in blindness if not treated. Closed-angle glaucoma can present gradually or suddenly. The sudden presentation may involve severe eye pain, blurred vision, mid-dilated pupil, redness of the eye, and nausea. Vision loss from glaucoma, once it has occurred, is permanent. Eyes affected by glaucoma are referred to as being glaucomatous.

Myopia Problem with distance vision

Myopia, also known as near-sightedness and short-sightedness, is an eye disorder where light focuses in front of, instead of on, the retina. As a result, distant objects appear blurry while close objects appear normal. Other symptoms may include headaches and eye strain. Severe near-sightedness is associated with an increased risk of retinal detachment, cataracts, and glaucoma.

Cataract Clouding of the lens inside the eye, which leads to low vision

A cataract is a cloudy area in the lens of the eye that leads to a decrease in vision. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry or double vision, halos around light, trouble with bright lights, and trouble seeing at night. This may result in trouble driving, reading, or recognizing faces. Poor vision caused by cataracts may also result in an increased risk of falling and depression. Cataracts cause half of all cases of blindness and 33% of visual impairment worldwide.

The National Eye Institute (NEI) was established in 1968. It is located in Bethesda, Maryland. The NEI is one of 27 institutes and centers of the US National Institutes of Health (NIH), an agency of the US Department of Health and Human Services. The mission of NEI is to prolong and protect the vision of the American people. The NEI conducts and performs research into treating and preventing diseases affecting the eye or vision.

Heterochromia iridum Difference in coloration, usually of the iris but also of hair or skin

Heterochromia is a variation in coloration. The term is most often used to describe color differences of the iris, but can also be applied to color variation of hair or skin. Heterochromia is determined by the production, delivery, and concentration of melanin. It may be inherited, or caused by genetic mosaicism, chimerism, disease, or injury. It occurs in humans and certain breeds of domesticated animals.

Uveitis Inflammation of the uvea of the eye

Uveitis is the inflammation of the uvea, the pigmented layer that lies between the inner retina and the outer fibrous layer composed of the sclera and cornea. The uvea consists of the middle layer of pigmented vascular structures of the eye and includes the iris, ciliary body, and choroid. Uveitis is described anatomically, by the part of the eye affected, as anterior, intermediate or posterior, from front to back. In the panuveitic form, all parts are involved. The commonest is the anterior form. Symptoms include pain, floaters and blurred vision, and clinical examination may show redness and an irregular pupil, while ophthalmic examination shows dilated ciliary blood vessels and the presence of cells in the anterior chamber. Uveitis may arise spontaneously and associated with some genetic factors, or be associated with a wide range of conditions including autoimmune disease and infections. While the eye is a relatively protected environment, its immune mechanisms may be overcome resulting in inflammation and tissue destruction associated with T-cell activation. The incidence is approximately 1:4500, most commonly between the ages of 20–60.

Tear gas Non-lethal chemical weapon

Tear gas, also known as a lachrymator agent or lachrymator, sometimes colloquially known as "mace" after an early commercial aerosol, is a chemical weapon that stimulates the nerves of the lacrimal gland in the eye to produce tears. In addition, it can cause severe eye and respiratory pain, skin irritation, bleeding, and blindness. Common lachrymators both currently and formerly used as tear gas include pepper spray, PAVA spray (nonivamide), CS gas, CR gas, CN gas, bromoacetone, xylyl bromide and Mace.

Eye injury Physical or chemical injuries of the eye

Physical or chemical injuries of the eye can be a serious threat to vision if not treated appropriately and in a timely fashion. The most obvious presentation of ocular (eye) injuries is redness and pain of the affected eyes. This is not, however, universally true, as tiny metallic projectiles may cause neither symptom. Tiny metallic projectiles should be suspected when a patient reports metal on metal contact, such as with hammering a metal surface. Corneal foreign body is one of the most common preventable occupational hazard. Intraocular foreign bodies do not cause pain because of the lack of nerve endings in the vitreous humour and retina that can transmit pain sensations. As such, general or emergency department doctors should refer cases involving the posterior segment of the eye or intraocular foreign bodies to an ophthalmologist. Ideally, ointment would not be used when referring to an ophthalmologist, since it diminishes the ability to carry out a thorough eye examination.

Visual impairment, also known as vision impairment, is a medical definition primarily measured based on an individual's better eye visual acuity; in the absence of treatment such as correctable eyewear, assistive devices, and medical treatment– visual impairment may cause the individual difficulties with normal daily tasks including reading and walking. Low vision is a functional definition of visual impairment that is chronic, uncorrectable with treatment or correctable lenses, and impacts daily living. As such low vision can be used as a disability metric and varies based on an individual's experience, environmental demands, accommodations, and access to services. The American Academy of Ophthalmology defines visual impairment as the best-corrected visual acuity of less than 20/40 in the better eye, and the World Health Organization defines it as a presenting acuity of less than 6/12 in the better eye. The term blindness is used for complete or nearly complete vision loss.

Lutein Chemical compound: naturally occurring carotenoid

Lutein is a xanthophyll and one of 600 known naturally occurring carotenoids. Lutein is synthesized only by plants, and like other xanthophylls is found in high quantities in green leafy vegetables such as spinach, kale and yellow carrots. In green plants, xanthophylls act to modulate light energy and serve as non-photochemical quenching agents to deal with triplet chlorophyll, which is overproduced at very high light levels, during photosynthesis. See xanthophyll cycle for this topic.

Zeaxanthin Chemical compound

Zeaxanthin is one of the most common carotenoids in nature, and is used in the xanthophyll cycle. Synthesized in plants and some micro-organisms, it is the pigment that gives paprika, corn, saffron, goji (wolfberries), and many other plants and microbes their characteristic color.

Sympathetic ophthalmia (SO), also called spared eye injury, is a diffuse granulomatous inflammation of the uveal layer of both eyes following trauma to one eye. It can leave the affected person completely blind. Symptoms may develop from days to several years after a penetrating eye injury. It typically results from a delayed hypersensitivity reaction.

Burt Kushner is an American pediatric ophthalmologist specializing in the diagnosis and treatment of strabismus. Kushner's contributions include demonstration of improved visual fields of patients following strabismus surgery, elucidation of torsional contribution to patients with diplopia, corticosteroid treatment of periocular capillary hemangioma, and novel hypotheses on the mechanism of "overacting" extraocular muscles.

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an acquired inflammatory uveitis that belongs to the heterogenous group of white dot syndromes in which light-coloured (yellowish-white) lesions begin to form in the macular area of the retina. Early in the course of the disease, the lesions cause acute and marked vision loss that ranges from mild to severe but is usually transient in nature. APMPPE is classified as an inflammatory disorder that is usually bilateral and acute in onset but self-limiting. The lesions leave behind some pigmentation, but visual acuity eventually improves even without any treatment.

Trauma in children Medical condition

Trauma in children, also known as pediatric trauma, refers to a traumatic injury that happens to an infant, child or adolescent. Because of anatomical and physiological differences between children and adults the care and management of this population differs.

Marie Diener-West is the Helen Abbey and Margaret Merrell Professor of Biostatistics and the chair of the Master of Public Health Program at Johns Hopkins Bloomberg School of Public Health. Diener-West is an editor for the Cochrane Eyes and Vision Group and a member of the American Public Health Association, American Statistical Association, Association for Research in Vision and Ophthalmology, and the Society for Clinical Studies.

Globe rupture is a condition where the integrity of the outer membranes of the eye are disrupted by blunt or penetrating trauma, usually resulting from a full-thickness injury to the cornea or sclera. It may also result from damage caused by chemicals such as strong acids or toxic chemicals such as lewisite.

Laundry detergent pod

Laundry detergent pods are water-soluble pouches containing highly concentrated laundry detergent, softener and other laundry products. Notable brands of these packs include All, Arm & Hammer, Gain, Purex, Persil and Tide. They first became popular in February 2012 when they were introduced by Procter & Gamble as Tide Pods.

Choroidal nevus Medical condition

Choroidal nevus is a type of eye neoplasm that is classified under choroidal tumors as a type of benign (non-cancerous) melanocytic tumor. A choroidal nevus can be described as an unambiguous pigmented blue or green-gray choroidal lesion, found at the front of the eye, around the iris, or the rear end of the eye.

References

  1. 1 2 Zentani A, Burslem J (December 2009). "Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 4: use of litmus paper in chemical eye injury". Emerg Med J. 26 (12): 887. doi:10.1136/emj.2009.086124. PMID   19934140.
  2. 1 2 3 4 Hodge C, Lawless M (July 2008). "Ocular emergencies". Aust Fam Physician. 37 (7): 506–9. PMID   18592066.
  3. Saini JS, Sharma A (February 1993). "Ocular chemical burns-clinical and demographic profile". Burns. 19 (1): 67–69. doi:10.1016/0305-4179(93)90104-G.
  4. 1 2 Haring RS, Sheffield ID, Channa R, Canner JK, Schneider EB (August 2016). "Epidemiologic Trends of Chemical Ocular Burns in the United States". JAMA Ophthalmology. 134: 1119–1124. doi: 10.1001/jamaophthalmol.2016.2645 . PMID   27490908.
  5. Haring, R. S.; Sheffield, I. D.; Frattaroli, S (2 February 2017). "Detergent Pod–Related Eye Injuries Among Preschool-Aged Children". JAMA Ophthalmology. doi:10.1001/jamaophthalmol.2016.5694.