Caustic keratoconjunctivitis - Revision history

Rossdonaldson1 at 17:14, 4 February 2026

2026-02-04T17:14:08Z

← Older revision		Revision as of 17:14, 4 February 2026
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	{{Caustics background}}		{{Caustics background}}

	{{Keratoconjunctivitis Types}}		{{Keratoconjunctivitis Types}}
			{{Conjunctivitis DDX}}

	==Clinical Features==		==Clinical Features==
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	==Differential Diagnosis==		==Differential Diagnosis==
	{{Caustic burn types}}		{{Caustic burn types}}

	~~{{Conjunctivitis DDX}}~~

	{{Unilateral red eye DDX}}		{{Unilateral red eye DDX}}
			{{Bilateral Red Eyes}}

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Clinical Features */

2024-02-28T23:08:05Z

Clinical Features

← Older revision		Revision as of 23:08, 28 February 2024
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	==Clinical Features==		==Clinical Features==
			[[File:Chemical burn injury..jpg\|thumb\|Complication of an alkali corneal burn causing ocular surface failure with neovascularisation, opacificatio,n and blindness.]]
	*Severe [[eye pain\|ocular pain]], blepharospasm, reduced [[vision loss\|visual acuity]]		*Severe [[eye pain\|ocular pain]], blepharospasm, reduced [[vision loss\|visual acuity]]
	*Altered ocular pH (normal = 7.0-7.2)		*Altered ocular pH (normal = 7.0-7.2)

ClaireLewis at 16:07, 5 October 2019

2019-10-05T16:07:37Z

← Older revision		Revision as of 16:07, 5 October 2019
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	==Clinical Features==		==Clinical Features==
	*Severe ocular pain, blepharospasm, reduced visual acuity		*Severe [[eye pain\|ocular pain]], blepharospasm, reduced [[vision loss\|visual acuity]]
	*Altered ocular pH (normal = 7.0-7.2)		*Altered ocular pH (normal = 7.0-7.2)
	*Appearance		*Appearance
	**Conjunctival injection '''OR''' blnnching		**[[red eye\|Conjunctival injection]] '''OR''' blnnching
	**Chemosis, hemorrhage, epithelial defects		**Chemosis, hemorrhage, epithelial defects
	**Corneal loss '''OR''' edema		**Corneal loss '''OR''' edema
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	*Rapid penetration through cornea and anterior chamber		*Rapid penetration through cornea and anterior chamber
	*Causes liquefaction necrosis from hydroxyl ions combining with fatty acids		*Causes liquefaction necrosis from hydroxyl ions combining with fatty acids
	*Elevated IOP may be seen in alkali injury<ref>Lin, M.P., et al., Glaucoma in patients with ocular chemical burns. American journal of ophthalmology, 2012. 154(3): p. 481-485 e1.</ref>		*Elevated [[IOP]] may be seen in alkali injury<ref>Lin, M.P., et al., Glaucoma in patients with ocular chemical burns. American journal of ophthalmology, 2012. 154(3): p. 481-485 e1.</ref>
	*Acute injury liquefaction necrosis and ischemia which can be graded on degree of limbal and corneal involvement		*Acute injury liquefaction necrosis and ischemia which can be graded on degree of limbal and corneal involvement
	*Early sequelae corneal edema and elevated IOP		*Early sequelae corneal edema and elevated IOP
	*Later injury after one week - corneal breakdown, ulceration, perforation because of collagenase activity exceeds synthesis		*Later injury after one week - corneal breakdown, [[corneal ulcer\|ulceration]], perforation because of collagenase activity exceeds synthesis

	===[[Caustic burns\|Acid Exposure]]===		===[[Caustic burns\|Acid Exposure]]===
	*Injury related to length of exposure and concentration of chemical		*Injury related to length of exposure and concentration of chemical
	*Causes coagulation necrosis and protein precipitation thus limits depth of penetration		*Causes coagulation necrosis and protein precipitation thus limits depth of penetration
	*Delayed complications corneal and conjunctival scarring, vascularization, glaucoma, uveitis		*Delayed complications corneal and conjunctival scarring, vascularization, [[glaucoma]], [[uveitis]]

	===Other Chemicals===		===Other Chemicals===

Rossdonaldson1: /* Background */

2018-11-20T21:25:25Z

Background

← Older revision		Revision as of 21:25, 20 November 2018
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	{{Caustics background}}		{{Caustics background}}

			{{Keratoconjunctivitis Types}}

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Disposition */

2018-11-20T21:20:08Z

Disposition

← Older revision		Revision as of 21:20, 20 November 2018
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	==Disposition==		==Disposition==
	*Admit ~~for:~~		===Admit===
	**Pediatric patient		*Pediatric patient
	**Corneal haziness, opacity, or limbal ischemia (paleness at limbus)		*Corneal haziness, opacity, or limbal ischemia (paleness at limbus)
	*Discharge ~~with~~ 24hr ophthalmology follow-up if only has corneal epithelial injury
			===Discharge===
			''With 24hr ophthalmology follow-up''
			*If only has corneal epithelial injury
	**Encourage use of artificial tears and other lubricating eyedrops		**Encourage use of artificial tears and other lubricating eyedrops

Rossdonaldson1: /* See Also */

2018-11-20T21:16:47Z

Rossdonaldson1: /* Management */

2018-02-24T19:46:17Z

Management

@@ Line 59: / Line 59: @@
 ==Management==
-*Eye irrigation
+{{Caustic ocular exposure managment}}
 ==Disposition==

Rossdonaldson1: /* Acid Exposure */

2018-02-24T19:25:52Z

Acid Exposure

← Older revision		Revision as of 19:25, 24 February 2018
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	*Later injury after one week - corneal breakdown, ulceration, perforation because of collagenase activity exceeds synthesis		*Later injury after one week - corneal breakdown, ulceration, perforation because of collagenase activity exceeds synthesis

	===Acid Exposure===		===[[Caustic burns\|Acid Exposure]]===
	*Injury related to length of exposure and concentration of chemical		*Injury related to length of exposure and concentration of chemical
	*Causes coagulation necrosis and protein precipitation thus limits depth of penetration		*Causes coagulation necrosis and protein precipitation thus limits depth of penetration
	*Delayed complications corneal and conjunctival scarring, vascularization, glaucoma, uveitis		*Delayed complications corneal and conjunctival scarring, vascularization, glaucoma, uveitis

	===Other Chemicals===		===Other Chemicals===
	*Most exposures produce only simple irritation		*Most exposures produce only simple irritation

Rossdonaldson1: /* Alkali Burns */

2018-02-24T19:25:38Z

Alkali Burns

← Older revision		Revision as of 19:25, 24 February 2018
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	*Perilimbal ischemia (white ring around iris)		*Perilimbal ischemia (white ring around iris)
	**Concerning due to co-location of corneal stem cell layer (re-epitheliazation relies on migration of limbal stem cells)		**Concerning due to co-location of corneal stem cell layer (re-epitheliazation relies on migration of limbal stem cells)
	===~~Alkali~~ [[Burns]]===		===[[Caustic burns\|Alkali Burns]]===
	*Rapid penetration through cornea and anterior chamber		*Rapid penetration through cornea and anterior chamber
	*Causes liquefaction necrosis from hydroxyl ions combining with fatty acids		*Causes liquefaction necrosis from hydroxyl ions combining with fatty acids

Rossdonaldson1: /* Management */

2018-02-24T19:24:54Z

Management

← Older revision		Revision as of 19:24, 24 February 2018
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	==Management==		==Management==
	*~~Irrigation~~		*Eye irrigation
	**Immediate irrigation is the most important treatment for caustic ocular injury, and should be started before comprehensive evaluation		**Immediate irrigation is the most important treatment for caustic ocular injury, and should be started before comprehensive evaluation
	**Irrigate affected eye(s) with copious amounts of fluid (no consensus on volume or length of time)<ref>Chau JP, Lee DT, Lo SH. A systematic review of methods of eye irrigation for adults and children with ocular chemical burns. Worldviews Evid Based Nurs. 2012 Aug;9(3):129-38.</ref>		**Irrigate affected eye(s) with copious amounts of fluid (no consensus on volume or length of time)<ref>Chau JP, Lee DT, Lo SH. A systematic review of methods of eye irrigation for adults and children with ocular chemical burns. Worldviews Evid Based Nurs. 2012 Aug;9(3):129-38.</ref>

← Older revision		Revision as of 21:16, 20 November 2018
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	*[[Eye Algorithms (Main)]]		*[[Eye Algorithms (Main)]]
	*[[Caustic burns]]		*[[Caustic burns]]
			*[[Keratoconjunctivitis]]

	==References==		==References==