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Understanding Chemical Injury to the Eye: A Patient Guide

Chemical injury to the eye occurs when the eye comes into contact with harmful substances such as acids, alkalis, or other chemicals. These injuries can cause significant damage to the delicate structures of the eye, including the cornea, conjunctiva, and surrounding tissues. Here's what you need to know

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Acid Burns

Caused by acids such as sulfuric acid or hydrochloric acid, resulting in coagulative necrosis and tissue destruction.

Alkali Burns

Caused by alkaline substances like lye or ammonia, leading to liquefactive necrosis and deeper tissue penetration.

Causes

Signs &
Symptoms

Pain

Severe pain or discomfort in the affected eye.

Redness

The eye may appear red or bloodshot.

Blurred Vision

Vision may become
blurry or impaired

Tearing

Excessive tearing or
watering of the eye

Photophobia

Increased sensitivity
to light.

Foreign Body Sensation

Feeling like there is something in the eye.

Eyelid Swelling

Swelling of the eyelids due to inflammation.

Treatment of Chemical Injury

  • 1 Emergency Eye Wash
    Immediately flush the eye with copious amounts of clean water to dilute and remove the chemical from the eye's surface. Thorough irrigation is crucial within the first few seconds to minutes after exposure.
  • 2 Medical Evaluation
    Seek prompt medical attention from an eye care specialist, such as Dr. Arpit Shah, Cornea and External Eye Diseases Surgeon at Shriram Super Speciality Eye Hospital, for a comprehensive evaluation and treatment.
  • 3 Medication
    Topical antibiotics, corticosteroids, and lubricating eye drops may be prescribed to prevent infection, reduce inflammation, and promote healing.
  • 4 Amniotic Membrane Transplantation
    In severe cases of chemical injury, amniotic membrane transplantation (AMT) may be performed. The amniotic membrane, obtained from the placenta, is used as a biological bandage to promote tissue repair, reduce inflammation, and prevent scarring.

Amniotic Membrane Transplantation (AMT) Surgery

What is Amniotic Membrane Transplantation?

Amniotic membrane transplantation (AMT) is a surgical procedure that involves the use of the amniotic membrane (the innermost layer of the placenta) to repair or regenerate the ocular surface. The amniotic membrane has unique properties that make it ideal for this purpose: it is anti-inflammatory, anti-fibrotic, anti-scarring, and promotes epithelial healing. It is used in various ophthalmic conditions to enhance wound healing and reduce inflammation.

Chemical Burns

To promote healing and reduce inflammation in cases of chemical injury to the eye.

Thermal Burns

To manage and heal the ocular surface after burns caused by heat.

Corneal Ulcers

Particularly those that are refractory to conventional treatments, to aid in healing and prevent perforation.

Persistent Epithelial Defects

When the corneal epithelium fails to heal on its own, AMT can facilitate closure.

Pterygium Surgery

To reduce recurrence and enhance healing after the surgical removal of a pterygium.

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

To manage acute stages and support ocular surface healing.

Limbal Stem Cell Deficiency

As part of treatments for limbal stem cell deficiency, such as SLET (Simple Limbal Epithelial Transplantation).

Conjunctival Surface Reconstruction

For reconstructing the conjunctival surface in cases of scarring or cicatrization.

Symblepharon Formation

To prevent or treat adhesion between the eyelid and the eyeball.

Corneal Perforations and Descemetocele

To provide tectonic support and promote healing.

Procedure

The procedure for AMT involves several key steps

  • 1 Preparation
    The eye is prepared and anesthetized using topical or local anesthesia.
  • 2 Harvesting the Amniotic Membrane
    The amniotic membrane is sourced from a placenta donated after cesarean section. It is thoroughly screened for infectious diseases and preserved until use.
  • 3 Placement
    The amniotic membrane is carefully trimmed to the required size and shape. It is then placed on the affected area of the eye, with the epithelial side up, facing the ocular surface.
  • 4 Securing the Membrane
    The membrane is secured in place using sutures, fibrin glue, or both. In some cases, a bandage contact lens is placed over the membrane to protect it and enhance patient comfort.
  • 5 Postoperative Care
    Patients are typically prescribed topical antibiotics, corticosteroids, and lubricants to prevent infection, control inflammation, and keep the ocular surface moist.

Advantages of AMT

Promotes Healing

The amniotic membrane provides a scaffold that supports cell growth and tissue regeneration.

Reduces Inflammation

Its anti-inflammatory properties help manage inflammation and reduce scarring.

Prevents Fibrosis

By reducing fibrosis, AMT helps maintain the clarity and function of the cornea and conjunctiva.

Biocompatibility

The membrane is biocompatible and well-tolerated by patients.

Conclusion

Amniotic membrane transplantation is a versatile and effective surgical technique for treating various ocular surface disorders. It offers significant benefits in terms of promoting healing, reducing inflammation, and preventing scarring. If you have any ocular surface conditions that might benefit from AMT, please consult Dr. Arpit Shah at Shriram Super Speciality Eye Hospital. Our experienced team is dedicated to providing advanced eye care solutions and ensuring the best possible outcomes for our patients.

Preventive Measures to Avoid Chemical Injury

Handle chemicals with caution and follow safety protocols, including wearing appropriate protective eyewear and gloves.

Store household cleaning products and chemicals out of reach of children and pets.

Avoid rubbing or touching the eyes with dirty hands or contaminated objects.

Immediately rinse the eye with water in case of accidental exposure to chemicals and seek medical attention promptly.

Simple Limbal Epithelial Transplantation (SLET) Surgery

What is SLET Surgery?

Simple Limbal Epithelial Transplantation (SLET) is a surgical technique used to treat limbal stem cell deficiency (LSCD). The limbus is the border area between the cornea and the sclera, and it contains stem cells essential for the regeneration and repair of the corneal epithelium. In LSCD, these stem cells are damaged or destroyed, leading to a range of ocular problems, including corneal opacity, neovascularization, and vision loss.

Indications for SLET Surgery

SLET surgery is indicated for patients with unilateral or bilateral limbal stem cell deficiency caused by

Chemical or Thermal Burns
Infectious Diseases
Autoimmune Disorders
Surgical Trauma
Congenital Aniridia

Procedure

SLET surgery involves the following steps

  • 1 Donor Tissue Harvesting
    A small biopsy of limbal tissue (approximately 2 mm) is taken from the patient's healthy eye. If both eyes are affected, donor tissue may be obtained from a living related donor or a cadaveric source.
  • 2 Recipient Eye Preparation
    The conjunctivalized or scarred corneal surface of the recipient eye is carefully removed to prepare the bed for the transplant.
  • 3 Graft Preparation
    The harvested limbal tissue is divided into tiny pieces.
  • 4 Graft Transplantation
    The small pieces of limbal tissue are distributed evenly over the prepared corneal surface. These pieces act as "seeds" of stem cells.
  • 5 Amniotic Membrane Application
    An amniotic membrane is placed over the transplanted tissue fragments to provide a supportive environment for the stem cells to grow and proliferate. The amniotic membrane is secured with sutures or tissue adhesive.
  • 6 Postoperative Care
    The eye is bandaged with a contact lens to protect the grafts and promote healing. Patients are prescribed topical antibiotics, anti-inflammatory medications, and sometimes immunosuppressive drugs to prevent rejection and infection.

Advantages of SLET Surgery

Minimally Invasive

Requires only a small biopsy of donor tissue, reducing the risk to the donor eye.

Effective for Unilateral LSCD

Particularly beneficial for patients with unilateral disease, as the healthy eye can serve as the donor.

Simple Technique

Does not require complex laboratory facilities or extended cultivation of stem cells.

High Success Rate

Demonstrated to be effective in restoring corneal clarity and improving vision in many cases.

Conclusion

SLET surgery is a promising and effective treatment for limbal stem cell deficiency, offering a simpler and less invasive alternative to other transplantation techniques. It leverages the patient's own stem cells to promote healing and restore vision, making it a valuable option in the management of LSCD.

For more information or to schedule a consultation, please contact Dr. Arpit Shah at Shriram Super Speciality Eye Hospital. Our team of experts is dedicated to providing the highest quality eye care and advanced surgical treatments.

Dr. Arpit Shah's Expertise

Chemical injuries to the eye can have serious consequences and require immediate action. If you experience a chemical injury or have concerns about eye safety, seek prompt medical attention.

Dr. Arpit Shah is a leading cornea surgeon renowned for his expertise in managing ocular surface diseases, including chemical injuries to the eye. With a focus on preserving vision and restoring ocular health, Dr. Shah specialises in advanced treatments such as amniotic membrane transplantation and limbal stem cell transplantation. Patients trust Dr. Shah's skill and dedication to providing personalised care and achieving optimal outcomes for ocular surface conditions.

Conclusion

Chemical injuries to the eye can cause significant damage and require immediate medical attention. If you experience a chemical injury, rinse your eye with water or saline and seek prompt evaluation by an eye care professional, such as Dr. Arpit Shah. With his expertise in ocular surface diseases, Dr. Shah can provide comprehensive treatment options tailored to your specific needs, promoting healing and preserving vision for the future