Corneal and Conjunctival Burns

The degree of damage to the cornea and conjunctiva from acid or alkali etching depends on the exposure time and the concentration of the caustic.


 * the acids cause coagulation necrosis, which prevents deep damage to the cornea
 * the principles cause colliquative necrosis, which goes deep and causes more serious injury

The most common substances that cause burns

 * lime
 * sulfuric acid
 * hydrochloric acid

Injury Description

 * minor injuries cause necrosis of the corneal epithelium and occlusion of the perilimbal vessels, which prolongs or hinders healing
 * severe injuries cause necrosis of the cornea and sclera

Visible changes

 * pseudopterygium – a fibrovascular membrane that grows over the clouded cornea
 * symblepharon – adhesions between the lid and bulbar conjunctiva as a result of conjunctival scarring
 * ectropion – scarring causes the edge of the lids to turn away from the bulb
 * trichiasis – eyelashes turn against the bulb and thereby traumatize the conjunctiva and cornea
 * inflammatory uveal reaction
 * secondary glaucoma

Degrees of etching

 * 1st degree : congestion of the eyelids, conjunctivae, mucous secretion, erosion of the eye surface (heals ad integrum)
 * 2nd degree : previous signs, in addition blisters and the formation of ischemic foci (small corneal opacities remain, possibly symblepharon)
 * 3rd degree : skin necrosis, ischemic changes, vessel occlusion, boiled fish eye - clouded cornea (prolonged healing, dry eye, corneal vascularization)
 * 4th degree : charring (loss of the eye)

First Aid

 * remove the caustic with any suitable solution
 * mechanically clean the eyelids, cornea, conjunctivae
 * transfer to the eye clinic: prevent secondary infection - application of ATB, corticosteroids (used only in the first phase of healing)
 * treatment of eyelid position, symblefares, pseudopterygia, trichiasis
 * in case of damage to the lacrimal apparatus and lack of tears, the application of artificial tears

Related Articles

 * Eye
 * Eye examination. Distribution of basic faults by perimeter