What is the role of drug treatment for 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

Medical therapy following irrigation in chemical injuries is geared toward promoting epithelial healing, preventing infection, eliminating inflammation, preventing glaucomatous damage from increased IOP, and controlling pain.

Epithelial healing is promoted through aggressive lubrication, ascorbate replenishment, and judicious use of topical corticosteroids. Artificial tears and ointments are especially important with severely scarred and exposed eyes, best recommended in a preservative-free form in anticipation of frequent prolonged use. Ascorbate, both oral and topical, aids in the synthesis of collagen fibrils. Topical steroids decrease ocular surface inflammation, facilitating new epithelial cell growth and ocular surface regeneration. The presence of epithelial defects and corneal exposure necessitates the use of prophylactic topical antibiotics to prevent infection in the already compromised eye.

Antibiotic ointments can serve the dual purpose of providing lubrication and preventing infection. Broad-spectrum antibiotic coverage is required to most effectively minimize infection risk.

Moderate and severe injuries often stimulate an increase in IOP due to anterior chamber inflammation and collagen fibril shortening. This condition is treated most effectively with aqueous suppressants, especially oral carbonic anhydrase inhibitors and topical beta-adrenergic blockers.

Inflamed eyes often experience ciliary spasm, which can be painful. This spasm is blocked by relatively long-acting mydriatic cycloplegics. In severe chemical injuries, oral pain medication may be required to comfort the patient.


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