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Chemical burn treatment11/30/2023 ![]() There is often product information on this packaging including chemical composition. If available, it is helpful to obtain the packaging of the chemical. The patient should be asked when the injury occurred, whether they rinsed their eyes afterwards and for how long, the mechanism of injury (was the chemical under high pressure?), the type of chemical that splashed in the eye, and whether or not they were wearing eye protection. It is therefore critical to take a careful history to document these factors. The severity of ocular injury depends on four factors: the toxicity of the chemical, how long the chemical is in contact with the eye, the depth of penetration, and the area of involvement. However, even protective goggles are no match for chemicals under high pressure. Since the majority of injuries occur at work, protective eye shields are mandatory when handling potentially corrosive substances ( OSHA regulation, 1910.133). The one exception to this is hydrofluoric acid, where the fluoride ion rapidly penetrates the thickness of the cornea and causes significant anterior segment destruction. The coagulated proteins act as a barrier to prevent further penetration (unlike alkali injuries). They cause damage by denaturing and precipitating proteins in the tissues they contact. AcidsĪcids are generally less harmful than alkali substances. ![]() The damaged tissues then secrete proteolytic enzymes, which lead to further damage. They saponify the fatty acids of cell cell membranes, penetrate the corneal stroma and destroy proteoglycan ground substance and collagen bundles. Īlkali agents are lipophilic and therefore penetrate tissues more rapidly than acids. Common causes of alkali and acid injuries are listed below. EtiologyĬhemical injuries occur as a result of acid, alkali, or neutral agents, with alkalis being responsible for 60%. Alkali materials are found more commonly in building materials and cleaning agents and occur more frequently than acid injuries. A minority of injuries occur in the home or secondary to assault. The vast majority of the injuries occur in the workplace as a result of industrial accidents. About two thirds of these injuries occur in young men and children age 1-2 years are particularly at risk. ICD-9-CM 940.2 alkaline chemical burn to cornea and conjunctiva, 940.3 acid chemical burn to the cornea and conjunctiva, 372.06 chemical conjunctivitis ICD-10-CM T26.60XA Corrosion of cornea and conjunctival sac, unspecified eye, initial encounter.Ĭhemical injuries to the eye represent between 11.5%-22.1% of ocular traumas. ![]()
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