Outcome of Immediate Management in Chemical Ocular Burns

Purpose: To evaluate the outcome of immediate management in acute ocular chemical burns. Methods: 29 eyes of 19 patients with acute chemical burns were studied. All patients received immediate first aid. Limbal and conjunctival involvement were graded as per Dua's classification. 86.8% patients with grade 1, 2 and 3 were managed conservatively while amniotic membrane transplantation was performed in 13.7% of patients who had grade 4 or grade 5 involvement. All patients were followed up for a period of 6 months. Results: 73.6% patients presented with alkali burns while 26.3% patients presented with acid burns. 3.4% eyes had grade I involvement, 55.1% eyes had grade II, 27.5% eyes had grade III, 3.4% eyes had grade IV and 3.4% had grade V involvement. Of 29 eyes, 86% showed epithelialization by 8 weeks, and rest 13.7% showed complete epithelialization by 4 months. On long term follow-up, complications were seen in 13.6% eyes. Symblepharon occurred in 6.8% eyes and rest 6.8% eyes developed corneal vascularization due to secondary limbal stem cell deficiency. None of the eyes showed worsening signs of corneal thinning and perforation. Conclusions: Immediate intervention in acute ocular burns, in the form of medical or surgical, prevents further ocular surface damage, promotes wound healing, and hinders visually debilitating cicatricial sequelae. In our experience, surgical intervention in patients with Grade 4 involvement and above leads to early rehabilitation and gain of visual function.