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Burn the cornea of the eye

 
, medical expert
Last reviewed: 26.06.2018
 
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In almost half the cases, patients who completely or partially lost sight were diagnosed with a "corneal burn of the eye".

What traumas are fatal for the cornea, how to treat burns and what measures should be taken to keep the vision? Let's figure it out.

trusted-source[1], [2], [3], [4], [5], [6], [7]

Epidemiology

Corneal burns account for 7-18% of eye injuries. The overwhelming majority (84%) are chemical burns. Thermal burns account for 16% of eye burns. The average age of patients with eye burns is 36 years and is more common in men than in women.

trusted-source[8], [9], [10], [11], [12], [13]

Causes of the burn the cornea of the eye

  1. Injury by particles of molten metals or liquids heated to high temperature, steam and fire (the cornea is endangered at a temperature that is above 45 ° C).
  2. Prolonged exposure to bright light: the cornea burns the eye with ultraviolet light when observing solar phenomena, the sun is too bright (for example, when staying in snow-capped mountains or watching the sea foam without goggles). In addition, if the safety rules are not observed during welding, it is easy to get a burn of the eye cornea by welding.
  3. Contact with chemicals: aggressive household chemicals, alkalis, acids, solvents.

The most dangerous burn of the cornea of the eye is an alkaline burn. If the acid damages only the area to which it hit, then the alkali is more insidious: it penetrates deeply into the tissues and acts more destructively.

trusted-source[14], [15], [16], [17], [18], [19]

Pathogenesis

The characteristic features of the burn of the cornea of the eye include the development of the pathological process and after the elimination of the damaging agent. This is due to the violation of metabolism in the eye tissues, the formation of toxins and the development of the immune response in the post-burn period. The vascular membrane is prone to repeated inflammation after a burn, there is a tendency to form adhesions, scars of the cornea and conjunctiva.

trusted-source[20], [21], [22], [23], [24], [25], [26]

Symptoms of the burn the cornea of the eye

For a person who has received a burn of the cornea of the eye, are characteristic:

  • headache;
  • unpleasant sensations from the light;
  • lacrimation;
  • narrowing of the field of vision or visual acuity;
  • uncontrollable contraction of circular eye muscles;
  • pain in the eyes;
  • sensation of foreign body in the eye.

If there was a burn of the cornea of the eye with ultraviolet, the first signs appear only after 8-10 hours.

trusted-source[27], [28], [29]

Stages

Degrees of burns are allocated depending on how seriously the cornea of the eye has been damaged.

  • I degree: injury to superficial layers of the cornea. It is characterized by a local increase in temperature and a minor edema of the eyelids. Inspection can reveal a slight tarnishing of the epithelium. Treatment of such trauma occurs outpatiently and does without consequences.
  • II degree: injury to all layers of the epithelium of the cornea. With such a burn, erosions appear on the cornea, blisters appear on the eyelids. A timely doctor's help will help restore vision, eliminating erosion without the formation of scars in a week or one and a half.
  • III degree: the cornea becomes turbid, but the pupil is clearly visible. The figure on the cornea is almost indistinguishable. A day after the injury, the folds of the decemet membrane form. Healing occurs after 2-4 weeks, there are small scars. The cornea becomes similar to frosted glass, the boundaries of the pupil can not be distinguished. After 3-4 weeks on the cornea, rough vascular leukoma is formed, and vision falls. Sometimes the conjunctiva grows.
  • IV degree: the cornea becomes dull gray, traumatizing to the full depth, reminiscent of porcelain. Often falls a clouded lens.

During the burn, the following stages are distinguished:

  1. Primary and secondary necrosis of cells (immediately after the injury and after - 2-3 weeks).
  2. Zone of splicing (partial restoration of the cornea).
  3. Inflammatory reaction as protection (lasts approximately 6 months).
  4. Scarring and dystrophy.

trusted-source[30], [31], [32], [33], [34], [35]

Diagnostics of the burn the cornea of the eye

To diagnose a burn is not difficult. But an accurate diagnosis in some cases can be made only after a while, because only after a few days it is possible to assess the degree of damage and especially its depth.

In case of a chemical burn, the cornea is almost transparent, while due to the lesion, the outer layers are torn off and the surviving part of the cornea becomes so thin that even a slight effort, eyelid closing or rough examination can result in perforation of the cornea. Most often these corneal layers become turbid over time, and the tissues become scarred.

When the eye is burned with an alkali, it first becomes translucent and only after a certain time, the unchanged action of alkaline compounds disrupts metabolic processes and leads to the appearance of a strong turbidity.

Careful examination and evaluation of the condition of the cornea, especially with the help of a slit lamp, allows to determine to some extent the extent of the lesion: with burns of the cornea, a slightly damaged epithelium is discarded, as well as damage to other layers, pathology of the endothelium, thinning of the cornea. Instrumental diagnostics, for example, ophthalmoscopy, will help to clarify the diagnosis. For example, if ophthalmoscopy detects an increase in the temperature of the nipple, this will indicate a greater degree of burn.

With minor burns, the study of the cornea with a special slit lamp makes it possible to determine such changes as it is almost impossible to detect a routine examination. These include subtle erosive changes in the cornea with electro-ophthalmia or as a result of burns with hydrogen sulfide, ammonia and similar compounds.

trusted-source[36], [37], [38], [39], [40]

Differential diagnosis

Differential diagnosis for corneal burn should separate the primary changes from developing secondary changes. The consequences and complications of extensive lesions of the conjunctiva and the marginal network of the cornea may appear even after a week.

To establish an accurate diagnosis, it is necessary to study the history of the patient: the type of burn, the amount and temperature of the chemical that damaged the cornea, how concentrated it was, etc.

Differential diagnostics makes it easy to distinguish a thermal burn from a chemical burn. Even if for some reason the patient can not himself provide this information, then by external signs it is easy to establish.

It is much more difficult for external manifestations to understand which substance has burned the cornea. It is easy to determine the burn of a slaked or quicklime lime, as the particles of matter remain on the conjunctiva. Because of the characteristic color of the substance, it is easy to determine the burn of the cornea of the eye with potassium permanganate, greenery, etc. To find out whether the acid was caused by an acid or an alkaline compound, methods of instrumental diagnostics will help: biochemical analysis, as well as microchemical analysis of conjunctival tissue.

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Treatment of the burn the cornea of the eye

Conservative treatment is aimed at preserving eyesight, preventing the consequences and complications that can develop both against the background of infections and due to trauma features. To do this, use:

  • antiseptic ointments;
  • non-hormonal anti-inflammatory and analgesic drugs;
  • preparations for activating microcirculation;
  • Novocain blockades;
  • antioxidants;
  • eye drops that restore the epithelium;
  • eye drops dilating the pupil.

On the first and second days after the corneal burn, the regeneration process is slower if compared with similar mechanical damages, as the surviving epithelium is still affected by the burn. Apply the ointment on the cornea and change the bandage every day should the doctor. When dressing, medicines for topical use are not used, since the bandage will be changed by a patient who can do it incorrectly. Removing the inflammation lasting approximately 7 days after the end of epithelization will be helped by drops with glucocorticoids and antiseptics.

With severe chemical burns, extensive lesions of the epithelium of the cornea, ocular membranes, with the development of concomitant infection, prolonged regeneration, or when conjunctival glands are conjoined with eyeball conjunctiva, consultation of the ophthalmologist is necessary.

Drops with burns of the cornea of the eye

  1. To remove the swelling, you can use the drops Visoptik, Vizin or Prokulin. According to the instruction, they drip into the eye 1 drop 3 times a day. Drops will help to cope with burning, remove swelling and calm the affected area. The maximum duration of treatment is 3 days.
  2. If the eye cornea burns a minor degree, but still causes discomfort, you can use drops of tetracaine, alkaine or a 2% solution of lidocaine. Drugs drip into the eye 2 times a day. They have approximately the same action: they eliminate pain, the cornea is frozen as it were. Such drops can not be used for longer than 2 days without consulting a doctor.
  3. To avoid infectious complications, antibiotics for topical use are used: Tobramycin, Levofloxacin, Oftakwix, Gentagut, Gentamicin and others. The course of treatment is 7 days. Drops are injected up to 5 times during the day.

With the destruction of the cornea or the threat of perforation, urgent surgical treatment is required: primary layer-by-layer keratoplasty (replacement of the damaged cornea or part of the transplant) or early through keratotomy (applying not sharp incisions to the cornea to weaken refraction along the strengthened axis). If there are indications, after 12-14 months after the cornea of the eye, an optical transplant or prosthetic repair of the cornea is performed, a plastic operation of the eyelid.

Non-medicamentous treatment of corneal burns of the eye additionally includes physiotherapeutic treatment and a special complex of massage for the eyelids. These techniques make sense to use in the recovery period, when the acute stage of inflammation is already behind. For early recovery, you should consult an ophthalmologist who will tell you which treatment will be effective with regard to the patient's condition. Corneal burns of the eye are too specific to be generalized - each case should be treated separately.

trusted-source[41], [42], [43], [44], [45], [46], [47], [48], [49]

Treatment of burns of the cornea of the eye - urgent homeopathy

Depending on what caused the burn of the cornea of the eye, the following homeopathic remedies are used:

  • Causticum - for burns that do not heal well.
  • Urtica urens with severe itching, swelling, and burns with poisonous plants.
  • With burns of 2 degrees, Echinacea ointment and tincture for ingesting 3 drops every 3 hours are applied.

Alternative treatment of eye cornea burn

The methods of alternative medicine make a significant contribution to the recovery process after chemical or thermal burn of the cornea of the eye. They contribute to the regeneration of tissues and the recovery of the eyeball.

Honey - is able to eliminate swelling, delaying excess fluid, promotes regeneration and prevents the loss of transparency of the cornea. Honey is used already when the first inflammation of the eye has passed. Honey is rich in vitamins - vitamins A, B, E, K, C, PP, pantothenic and folic acid - which are necessary for rapid tissue repair

Potato Compress. Raw potatoes are rubbed on a fine grater. Then, after putting on the gauze, put the potatoes and leave for 15-20 minutes.

You can make a compress from tea leaves, chamomile flowers or marigold. Tea brew (or herbs) is poured with boiling water, let it brew. Such a decoction can both be applied to the eyes, and used for washing.

For the removal of swelling and inflammation make frequent, but short - for 2-3 minutes - cold compresses.

trusted-source[50], [51], [52]

Herbal treatment for burns of the cornea

Compress from linden broth. For the compress 2 st. Spoons of dried linden flowers pour a glass of boiling water, let it brew and strain. In the broth, immersed cosmetic discs and put on the eyes. Disc is recommended to keep until it dries.

Another known alternative is aloe juice, which, like honey, contains a complex of substances that help to speed up the healing process.

Decoction of marigold. Dry flowers of calendula are poured with boiling water and allowed to stand in a closed container. This broth is washed with the eyes. Calendula eliminates edema, inflammation and relieves pain.

Decoction of chamomile or lungwort for ingestion also contributes to recovery.

Strangely enough, but the diet also affects the process of restoring the eye tissues: a menu rich in vitamins A and E, fish oil will help you recover faster after a burn and improve your eyesight.

Prevention

Preventive measures that prevent burns of the cornea of the eye, first of all, are aimed at eliminating risk factors and observance of safety precautions in contact with chemical and fire hazardous substances. To avoid ultraviolet burns, in clear sunny weather, you should not forget safety glasses with a light filter. If, however, the burn occurred, the patient in the recovery period should periodically visit an ophthalmologist.

Treatment of burns of the cornea of the eye is a long and difficult process, where the doctor requires knowledge and experience, and from the patient - scrupulousness and unswerving compliance with all recommendations. Only such a trip will ensure the success of treatment.

trusted-source[53], [54], [55], [56], [57], [58], [59]

Forecast

The forecast entirely depends on the type and depth of the lesion. Burns with chemicals rarely cause irreversible changes. The possibility of restoring the function of vision after burns of the cornea of the eye with acids or alkaline compounds is determined by the depth of the lesion.

trusted-source[60], [61]

It is important to know!

Touching hot surfaces (to an iron, a stove, a pan, etc.), to a flame, tipping over containers with a hot or boiling liquid, electric shock, contacts with acids, alkalis, bleach, lime, caustic soda - all this leads to burns. Read more..

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