[Ocular burns]

J Fr Ophtalmol. 2008 Sep;31(7):723-34. doi: 10.1016/s0181-5512(08)74391-2.
[Article in French]

Abstract

Ocular or thermal burns account for 7.7%-18% of ocular trauma. The majority of victims are young. The burns occur in the setting of accidents at work or in the home, or during a physical attack. Chemical burns by strong acids or bases are responsible for the most serious injuries. Associated with the destruction of limbal stem cells, they present as recurrent epithelial ulcerations, chronic stromal ulcers, deep stromal revascularization, conjunctival overlap, or even corneal perforation. The initial clinical exam is sometimes difficult to perform in the presence of burning symptoms. Nevertheless, it enables the physician to classify the injury, establish a prognosis, and most importantly, guide the therapeutic management. The Roper-Hall modification of the Hughes classification system is the most widely utilized, broken down into stages based on the size of the stromal opacity and the extent of possible limbal ischemia. This classification is now favorably supplemented by those proposed by Dua and Wagoner, which are based on the extent of the limbal stem cell deficiency. The prognosis of the more serious forms of ocular burns has markedly improved over the last decade because of a better understanding of the physiology of the corneal epithelium. Surgical techniques aimed at restoring the destroyed limbal stem cells have altered the prognosis of severe corneal burns. In order to decrease the incidence of burns, prevention, particularly in industry, is essential.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Accidents
  • Anti-Inflammatory Agents / therapeutic use
  • Biological Dressings
  • Burns, Chemical / epidemiology
  • Burns, Chemical / pathology
  • Burns, Chemical / therapy
  • Combined Modality Therapy
  • Conjunctiva / injuries
  • Corneal Injuries
  • Corneal Transplantation
  • Corneal Ulcer / etiology
  • Corneal Ulcer / surgery
  • Debridement
  • Epithelium, Corneal / pathology
  • Eye Burns* / classification
  • Eye Burns* / epidemiology
  • Eye Burns* / pathology
  • Eye Burns* / prevention & control
  • Eye Burns* / therapy
  • Female
  • Humans
  • Keratoplasty, Penetrating
  • Limbus Corneae / blood supply
  • Limbus Corneae / injuries
  • Limbus Corneae / surgery
  • Male
  • Mydriatics / therapeutic use
  • Ophthalmic Solutions / therapeutic use
  • Prognosis
  • Radiation Injuries / etiology
  • Radiation Injuries / therapy
  • Severity of Illness Index
  • Therapeutic Irrigation

Substances

  • Anti-Inflammatory Agents
  • Mydriatics
  • Ophthalmic Solutions