How is inflammation reduced following chemical burns to the eye?

Updated: Oct 08, 2019
  • Author: Mark Ventocilla, OD, FAAO; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Inflammatory mediators released from the ocular surface at the time of injury cause tissue necrosis, neovascularization, and scarring and attract further inflammatory reactants.

This robust inflammatory response not only inhibits reepithelialization but also increases the risk of corneal ulceration and perforation.

Controlling inflammation with topical steroids can help break this inflammatory cycle. Prednisolone acetate 1% should be used 4 times daily for 1 week in a mild chemical burn. Difluprednate and loteprednol etabonate are also extremely useful topical steroid preparations for chemical ocular-surface disease. The steroid dose should be increased to hourly dosing in more severe burns. Steroids should be discontinued or tapered rapidly by 10-14 days to avoid corneal melting.

Acetylcysteine (10% or 20% Mucomyst prepared in a certified compounding pharmacy) can inhibit collagenase to reduce corneal ulceration, yet its clinical use is currently controversial.


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