Diferencia entre revisiones de «Caustic keratoconjunctivitis»
Sin resumen de edición |
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| Línea 1: | Línea 1: | ||
==Background== | ==Background== | ||
Chemical burn to eye | *Chemical burn to eye | ||
*Alkali injuries are more severe than acidic injuries | |||
==Treatment== | ==Treatment== | ||
#Topical anesthesia (e.g. tetracaine) | #Topical anesthesia (e.g. tetracaine) | ||
# | # Copious irrigation in 15min intervals followed by pH check | ||
##until pH 7.0 (check with pH strip) | ##LR, NS, or 3% saline works best | ||
##Treat until pH is 7.5-8.0 (check with pH strip) | |||
###Avoid testing pH of the irrigation fluid (wait few min before checking ocular fluid) | |||
##alkaline exposure requires minimum of 4L over 40min | ##alkaline exposure requires minimum of 4L over 40min | ||
# Check IOP | # Check IOP | ||
# Consider cycloplegic (e.g. atropine) | # Consider cycloplegic (e.g. atropine) | ||
#Severe exposures may require anterior chamber irrigation | |||
==Disposition== | |||
##Admit all pts w/ corneal haziness or opacity or limbal ischemia (paleness at limbus) | |||
##Discharge w/ 24hr f/u if pt only has corneal epithelial injury (fluorescein uptake) | |||
==Prognosis== | |||
#After irrigation perform complete eye exam | |||
##Prognosis determined by extent of injury at limbus and area/depth of injury to cornea | |||
==See Also== | ==See Also== | ||
*[[Eye Algorithm (Main)]] | *[[Eye Algorithm (Main)]] | ||
*[[Burns]] | *[[Burns]] | ||
*[[Caustics]] | |||
[[Category:Ophtho]] | [[Category:Ophtho]] | ||
[[Category:Trauma]] | [[Category:Trauma]] | ||
[[Tox]] | |||
Revisión del 18:36 26 jul 2011
Background
- Chemical burn to eye
- Alkali injuries are more severe than acidic injuries
Treatment
- Topical anesthesia (e.g. tetracaine)
- Copious irrigation in 15min intervals followed by pH check
- LR, NS, or 3% saline works best
- Treat until pH is 7.5-8.0 (check with pH strip)
- Avoid testing pH of the irrigation fluid (wait few min before checking ocular fluid)
- alkaline exposure requires minimum of 4L over 40min
- Check IOP
- Consider cycloplegic (e.g. atropine)
- Severe exposures may require anterior chamber irrigation
Disposition
- Admit all pts w/ corneal haziness or opacity or limbal ischemia (paleness at limbus)
- Discharge w/ 24hr f/u if pt only has corneal epithelial injury (fluorescein uptake)
Prognosis
- After irrigation perform complete eye exam
- Prognosis determined by extent of injury at limbus and area/depth of injury to cornea