Assessment of severity and first aid

Chemical eye burns,
Traumatic apoptosis of corneal epithelium

The natural reaction of most parents when their child injures an eye, is panic accompanied with the impression that they should provide some form of  assistance to child immediately after the incident. The truth is that, with the exception of splashing some caustic liquid in the child's eye, no other type of injury requires immediate action and there is plenty of time for the smooth transfer of the child to a relevant specialist who can determine treatment.


Chemical eye burns

In an eye injury, parents and teachers have little to offer and only need to keep their cool and reassure the child by transferring him to the ophthalmologist for examination.

When coming into contact with a caustic or other toxic substance to the eye, parents and the child concerned should take steps to remove it as soon as possible. The longer the dangerous substance remains in the eye, the greater the damage it causes.

The easiest and fastest way to remove the harmful substance is to put the child with affected eye or eyes open under cold running water. The water will dilute the chemical which possibly stagnates in the eye, while the flow from the tap could help its removal.

Most chemicals are not so easy to remove and recommendation from ophthalmologists is that the eyes remain under the tap for at least 20 minutes. After this time has passed and we are sure that all of the harmful chemical has rinsed, then the child can be taken to the hospital to assess the extent of damage and to obtain appropriate treatment.

Some chemical compounds are more harmful than others. Although there is a general perception that acids are the most dangerous substances, usually damage caused by them is superficial and does not extend deeper into the eye.

On the other hand, alkalis such as caustic potash or ammonia, which is present in many household cleaners and fertilizers, have stronger erosive power and can penetrate inside the eye, causing damage even in structures such as the lens.

At the hospital the ophthalmologist will provide some drops of local anesthetic to reduce pain and allow the child time to calm down so he can examine it.

The final treatment depends on the type and extent of damage, but this is almost always a pharmaceutical therapy prescribed to suppress inflammation and prevent bacterial infections.


Traumatic apoptosis of corneal epithelium

It is perhaps the most common traumatic injury of the eye. Fortunately, it is among the most innocent.

Lacerations can come from anything: from a nail, a pillowcase, a contact lens,even from a lit cigarette.

The patient feels pain and the eye is red and weeping. The ophthalmologist assesses the extent of apoptosis by the use of a dye of flouoroseinis, which fills the area of deficit and becomes fluorescent when illuminated with a special blue light.

The apoptosis is generally treated in the next 1-2 days and the treatment includes antibiotic eye drops and artificial tear drops. In rare cases apoptosis can recur even repeatedly. The syndrome of recurrent apoptosis of corneal epithelium was also observed in some rare hereditary diseases.