This 40-year-old man had alkali thrown into his face today in a lovers' quarrel. The proper management is?
Incorrect. An eye shield is appropriate for hyphema, intraocular foreign body, and scleral laceration, but not for early management of chemical burn. Cycloplegic eye drops can be used to reduce inflammation and pain, but not as the first line of intervention. Try again!.
Incorrect. Antibiotic eye drops are appropriate prophylactically after a chemical burn, but an eye shield is not. Neither is the use of antibiotics. Another maneuver is indicated urgently. Try again!.
Incorrect. Although you may have to refer to an ophthalmologist if visual acuity or epithelial damage is noted, there is a more urgent intervention needed. Try again!.
Yes. This photograph shows typical signs of alkali burn, including corneal opacification and blanching of conjunctival vessels. Management includes immediate and copious irrigation for 10-15 minutes. You may wish to monitor the effectiveness of irrigation by repeated testing with a pH strip. An ophthalmologist must be consulted promptly. Management, which may include placement of an amniotic membrane graft, is complex.