Eye diseases. Eye burns (most important)

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Eye diseases. Eye burns (most important)

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39. Eye burns

The most common in children are thermal burns, burns with lime, potassium permanganate crystals, stationery glue. In children, burns are more severe than in adults. Particularly severe damage (colliquation necrosis) occurs with chemical burns, mainly with alkalis. Acid burns, especially sulfuric acid, are also very severe, but the acid does not penetrate deep into the tissue (coagulative necrosis).

According to severity, burns are divided into four degrees, taking into account their localization, size and condition (hyperemia, bladder, necrosis) of burned tissues. First-degree burns are characterized by edema and hyperemia of tissues, second-degree burns are blisters, erosions, and superficial, easily removable necrotic films. The burn of the third degree is characterized by necrosis, which captures the thickness of tissues with the formation of a grayish folded scab, and the fourth degree by necrotic changes in almost all membranes of the eye.

Third-fourth degree burns can be complicated by aseptic uveitis and endophthalmitis and end with eye atrophy. Another terrible complication of these burns is perforation of the necrotic capsule of the eye with prolapse of the membranes and subsequent death of the entire eye.

The consequences of damage to the skin and conjunctiva are cicatricial eversion and inversion of the eyelids, their shortening, leading to non-closure of the palpebral fissure and the formation of adhesions between the conjunctiva of the eyelids and the eyeball, symblepharon, which, unlike trachomatous, is anterior.

A burn can be caused by a chemical substance and hot foreign bodies that have entered the eye, as well as exposure to radiant energy, electric welding without goggles, and prolonged exposure to snow. Bright sunlight causes ultraviolet burns of the cornea and conjunctiva. There is a sharp photophobia, lacrimation, blepharospasm, edema and hyperemia of the mucous membrane. Biomicroscopy shows vesicles and erosions in the corneal epithelium. Watching a solar eclipse or molten glass or metal without protective goggles can cause infrared burns. The patient complains of the appearance of a dark spot before the eye.

Treatment. First aid for chemical burns of the eyes consists in abundant and prolonged washing of the burn surface of the conjunctival cavity with water, removing particles of the substance that has entered the eye. Further treatment is aimed at fighting the infection (local disinfectants are prescribed), improving the trophism of the cornea (subconjunctival injections of autologous blood with penicillin, vitamin drops and ointments are indicated. Due to insufficient oxygenation of the cornea, unithiol and cysteine are indicated. In order to prevent adhesions in severe burns, daily massage of the conjunctival arches with a glass rod after dicaine anesthesia.In case of burns of the third and fourth degree, urgent hospitalization in an eye hospital is indicated, plastic surgery is often recommended.

Author: Shilnikov L.V.

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