RT Book, Section A1 Duncan, Jacque L. A1 Parikh, Neeti B. A1 Seitzman, Gerami D. A2 Papadakis, Maxine A. A2 McPhee, Stephen J. A2 Rabow, Michael W. A2 McQuaid, Kenneth R. SR Print(0) ID 1193145004 T1 Chemical Conjunctivitis & Keratitis T2 Current Medical Diagnosis & Treatment 2023 YR 2023 FD 2023 PB McGraw-Hill Education PP New York, NY SN 9781264687343 LK accessmedicine.mhmedical.com/content.aspx?aid=1193145004 RD 2024/10/14 AB Chemical burns are treated by copious irrigation of the eyes as soon as possible after exposure, with tap water, saline solution, or buffering solution if available. Neutralization of an acid with an alkali or vice versa may cause further damage. Alkali injuries are more serious and require prolonged irrigation, since alkalies are not precipitated by the proteins of the eye as are acids. It is important to remove any retained particulate matter, such as is typically present in injuries involving cement and building plaster. This often requires eversion of the upper lid (eFigure 7–72). The pupil should be dilated with 1% cyclopentolate, 1 drop twice a day, to relieve discomfort, and prophylactic topical antibiotics should be started (Table 7–2). In moderate to severe injuries, intensive topical corticosteroids and topical and systemic vitamin C are also necessary. Complications include mucus deficiency, scarring of the cornea and conjunctiva, symblepharon (adhesions between the tarsal and bulbar conjunctiva), tear duct obstruction, and secondary infection. It is difficult to assess severity of chemical burns without slit-lamp examination.