LAUSR

Ocular chemical burns are true ophthalmic emergencies that require immediate and appropriate medical care. They are the most common cause of both unilateral and bilateral limbal stem cell deficiency in India,[1] thus being important contributors to the burden of preventable corneal blindness.[2] Unfortunately ocular burns tend to affect the younger productive population, mostly as a result of industrial accidents. The importance of urgent and adequate medical care of the acute phase, therefore, cannot be understated. First, we must clearly understand the goal of treatment, which is mainly to prevent disastrous consequences such as corneal melts and severe irreparable visual loss by hastening surface epithelization. Second, we must realize that there are multiple factors that can affect the outcome and visual prognosis in cases of ocular burns, some of which are beyond our control while others can be mitigated. These factors include the pH of the chemical (alkali or acid), the mode of impact and the depth of penetration of the chemical on the ocular surface, the interval between first contact and irrigation, and the duration between burn and treatment for ocular complications. The initial clinical evaluation is critical to recognize and gauge the extent of de‐epithelization of the ocular surface, discern subtle pockets of retained chemicals and identify the severity of limbal ischemia.[3] Simple techniques like double eversion of upper eyelid and fluorescein staining of the ocular surface, remain the cornerstone of a good clinical evaluation.