A 12-Year Analysis of Thermal and Chemical Ocular Burns: Insights into Management and Outcomes from a Single Burn Center.

Abstract

Acute ocular burns can lead to severe complications such as vision loss or eyelid contractures. While management strategies vary, no standardized algorithm exists. This study examines the etiology, management, and outcomes of ocular burns at a single burn center, with a focus on the differences between thermal and chemical burns. A retrospective cohort study was conducted on patients admitted with ocular burns to a burn center from 2012 to 2023. Data on demographics, injury characteristics, treatments, and outcomes were analyzed to identify differences in clinical presentation and management by burn type. Among 50 patients (84% male, mean age 39.4 ± 20.4 years) with 81 eyes affected, 78% of burns were thermal, 20% chemical, and 2% electrical. Visual acuity was worse in chemical burns (103.3 ± 111.3 vs. 67.0 ± 58.6), though not statistically significant. Chemical burns consistently received immediate irrigation (100% vs. 20.5%, p<.001) and more frequent anti-inflammatory treatment (70% vs. 23.1%, p=.009). Hospital stays were longer for thermal burns (24.1 ± 15.0 days vs. 3.7 ± 4.3 days, p=.037). Complications included two cases of significant vision loss and one case of entropion requiring multiple two surgeries. In summary, ocular burns differ significantly in management and outcomes depending on burn etiology. However, these differences in early management may reflect variations in clinical presentation and triage priorities, rather than differences in treatment importance. Standardized protocols that emphasize early ocular care for all burn types may help reduce variability in practice, particularly in thermal burns where systemic injuries often take priority.