Chemical Conjunctivitis
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Description
It is an inflammation of the eye caused by a chemical substance such as car battery acid, Snake venom, fluid from plants, Household cleaning chemicals. Alkali chemicals are more damaging to the eye than acids
Signs and Symptoms
- Pain
- Redness
- Watering, Pus discharge if secondarily infected
Investigations
Fluorescein staining will reveal the area of conjunctival corneal chemical erosion
Treatment
Emergency management
- Apply local anaesthetic – lignocaine 2% eye drops
- Wash the eye copiously with normal saline or tap water for about 30 minutes
Pharmacological
- Hydrocortisone 1% Eye Ointment. Apply 3-4 times daily
- Atropine eye drops 1% 2 times a day
- Tetracycline 1% eye ointment three times daily if infected
Other Medicines Used in Chemical Burns
- Vitamin C (Sodium ascorbate) 10% drops and a daily oral dose of ascorbic acid 1gm (assist in laying down of the corneal collagen)
- Collagenase inhibitors: L-cysteine and or Cenicillamine applied topically helpful in preventing corneal perforation
- Artificial tears: Prevents the effects of corneal drought. SNO tears, or Hypromellose 0.3%
- Bandage soft contact lenses prevent the formation of adhesions between eyelid and eyeball
- Sodium EDTA - Chelates calcium, a cofactor for the collagenase enzyme, thereby rendering the enzyme unavailable for corneal melting.
Late Treatment
- Division of adhesions between conjunctiva of the eye and eyelid.
- Place an eye shell between the divided bands during ball synechiealisis
- Conjunctiva grafting
- Eyelid surgery to correct the deformity
- Corneal grating after 6 - 12 months to allow for maximum resolution