Eye burns are a special emergency in ophthalmology because the condition is often severe and commonly affects both eyes. Many cases, even with timely emergency treatment, still leave serious complications that affect vision and aesthetics, or result in blindness. Therefore, urgent first aid in the initial moments after a burn can significantly limit the damage caused by the burn to the eyes.
 |
Burned Eye (Photo: biola) |
In peacetime, eye burns account for 6-10% of eye injury cases, primarily caused by chemicals, especially acid or alkaline burns, which are increasingly on the rise due to increased chemical production and misuse of chemicals.
Causes: Some victims are attacked with acid thrown in the face due to jealousy or personal vendettas, while others accidentally splash chemicals into their eyes during use or transportation, resulting in burns.
The prognosis of the injury, whether severe or mild, depends on the timing of treatment. The clinical picture primarily depends on the concentration and pH of the chemical, as well as the duration of exposure in the eyes.
– Dilute acids usually only cause mild and superficial damage.
– Concentrated or pure acids with a low pH
When acids come into contact with tissues, they cause sudden necrosis that coagulates surface proteins, thereby preventing the spread of chemicals. Acids do not penetrate deeply into the tissues of the eye, causing immediate damage. Prognosis can often be assessed right after the burn.
Burns from alkaline substances are the most serious because they dissolve cells upon contact, causing tissue softening, deep saponification reactions, cellular dehydration, and heat generation leading to burns. Burns are often severe due to the wide and deep penetration of the alkali into the eye, with effects lasting for many days. Prognosis is difficult to determine initially, and caution must be exercised even in cases where initial damage does not seem severe. The most dangerous alkalis are concentrated solutions, ammonium compounds, lime, and cement.
Initial Management:
The prognosis for burned eyes depends on immediate first aid in the early moments after the burn, making it essential to disseminate knowledge and guidelines for emergency management to everyone. The first urgent action is to remove the burning agent from the eye by rinsing with plenty of water, and continuing with saline or clean water. In the absence of clean water, even unclean water (pond, lake, or field water) should be used for rinsing the face.
The Effects of Eye Washing:
– Eliminates the burning agent from the eye.
– Reduces the concentration of the burning chemical.
– Assesses the extent of damage.
– Limits future complications.
Washing Method:
– Patients can wash their eyes themselves by immersing their face and eyes in water and trying to blink many times in the water to ensure thorough rinsing of the entire eye surface.
– Others can assist the patient by using a hose, bucket, or basin to pour water into the patient’s eyes while they lie on their back, keeping their eyes open, or with someone else helping to hold the eyelids open.
– The minimum amount of water used should be several liters.
– The washing duration should be at least 10 – 15 minutes.
Note: Absolutely do not rinse the eyes with neutralizing solutions of acids and bases against each other, as this will worsen the burning condition.
Thus, rinsing the eyes at the site of the accident is a simple yet highly valuable measure to ensure that the burning agent does not remain on the surface of the eyeball and conjunctival sacs, preventing it from penetrating the internal structures of the eye and preserving the physiological function of the eye. The quality of treatment outcomes is determined by the initial emergency response. After timely first aid, antibiotic ointment should be applied, and the patient should be referred to an ophthalmology specialist for further treatment. When transferring the patient, it is contraindicated to bandage the eyes; only cover them.
Attention: In cases of eye burns caused by lime, the lime must be completely removed before rinsing the eyes.
Preventing Burn Accidents:
– Educate everyone, especially students and workers, about the importance of preventing eye injury accidents.
– Improve working conditions and enhance safety measures for workers: In factories, workshops, and laboratories using chemicals, protective eyewear must be worn. Adequate emergency supplies, including eyewash stations, buckets of water, and clean water for rinsing the eyes, should be available.
– Strictly punish those who use chemicals to harm others for any reason.
– Prohibit children from standing near slaked lime pits or playing by throwing lime at each other.
– Areas where lime is slaked should be fenced off and marked with warning signs.
Dr. Le Hoc Han
