Chemical injuries& Blunt injuries

Prof. Dr. K. Srikanth

Chemical injuries

Alkali& Acid injuries

• Alkali; ( Ammonia, NaOh4) Lipophillic so they saponify the cell membranes,destroy collagen, proteoglycan.

• Mechanism of Damage;• They can penetrate the epithelium,cause occlusion of

limbal vasculature.• This leads to Anterior segment ischaemia ,cataract,

Symblepheron.

Chemical injury

Clinical features

• 1)Intense conjunctivitis, and chemosis

• 2) There may be varying corneal epithelial denudation

• 3) Cornea may be hazy due to edema

• 4) Limbal ischemia of varying degree may be present

Effects of chemical injury

• 1) Ocular surface injury results in severe DRY EYE

• 2) May result in SYMBLEPHERON

• 3) Limbal stem cell injury results in CORNEAL EPITHELIAL DEFECTS

• 4) Cornea may become opaque Ulceration can occur, entire cornea can be destroyed

Treatment

• 1) Immediate irrigation with Normal saline/ Water• 2) Remove any particulate matter• 3) Instill Antibiotic drops or ointment• 4) Cycloplegics to be applied• 5) Corticosteroids to reduce Inflammation• 6)Ascorbic Acid& Tetracyclines are used Topically to

prevent collagen lysis

MECHANICAL INJURIES

• Closed Globe Open Globe• a) Contusion a) Laceration• b) Lamellar Laceration b) Rupture

Mechanism of Blunt Trauma

Effects in the Anterior Segment

Effects on the Posterior Segment

Possible Questions• List the effects of Blunt trauma to the Eye.• Name 4 Posterior segment effects of Blunt Trauma• How do you classify Chemical injuries? How will you manage a

case of Alkali fall in the eye?