Index

burns, mechanism of

with chemically active foreign bodies, 67–68 with chemically reactive fluids

acids, 68 alkali, 68

detergents/solvents, 70 hydrofluoric acid, 70 peroxides, 68–70 thermal contact, 67

calcifications, 90 edema, 96–97 histology

Bowman’s membrane, 52 descemet’s membrane, 53 endothelium, 53–54

epithelium and basement membrane, 49–52 limbus, 54–55

stroma, 52–53 innervation, 55 leucoma, 101 nonhealing, 99–100 osmolarity, 56, 79, 82 pathophysiology of

decontamination on eye, 59–61 eye burns physiological barriers, 59 impregnation, 65, 66

irritation and burn, 64–65

limits of physiological decontamination, 63–64 local decontamination, 60–63

scratched, 90 transparency, 93–94 transparency, factors of

collagen structure, 55 intraocular pressure, 57 proteoglycans function, 55 recovery mechanism of, 56–57 regulation of hydration, 55–56 scarcity of cells in stroma, 55

ulceration, 98 fluorescein with, 96

superficial punctuate keratitis, 96 vascularization, 55

Corrosives

diffusion of, 40–41

time of contact, with eye, 41–42

D

Decontamination active d, 55

chemical d, 18, 43–46, 87 emergency d, 18

initial d, 9

Deep lamellar keratoplasty (DLK), 108 Descemet’s membrane, 53

Dilution and mechanical draining, 43–44 Diphoterine®, 36, 45, 71, 77–84, 87, 115

E

Ectropium–trichiasis, 101

Edema, of cornea, 96–97

Emergency care

active wash, 44–46

consequences of passive washing, 44 dilution and mechanical draining, 43–44

Emergency chain, 116 Emergency treatment

chemical emergency, 113–114 chemical ocular traumas, characteristics

and consequences, 113 first aid management, 114–115

management of chemical eye burns care by nonspecialists, 117

ophthalmological management, 117–118 ocular injury treatment

emergency chain definition, 116 safety obligations, 116–117

Endocular inflammation, 101 Endothelial cells, 53–54

Endothelium, 7, 53–56, 59, 70, 71, 78, 79, 82, 93, 108 Energetic levels

acid–base scale, 25–28

irritant power of acids/bases, 27 scales of chemical reactions, 27, 29

Epidemiology, 9–14 Epidemiology, of injuries

data limitations and scope

American Association of Poison Centers NDPS, 10 burn center/hospital studies, 13–14

individual publications, 9–10 occupational burn data, 9

US Bureau of Labor Statistics data, 10 work-related injury, 11

etiology

chemical substances, 14 complications of face peeling, 13 deliberate chemical assault, 11–13

Epithelium, of cornea basal cells, 51–52 intermediate cells, 51

lacrymal secretion, 49–50 necrosis, 97

superficial cells, 50–51 Exothermic reaction, 36 Extraocular signs, 99

Eyelid burns, surgical treatment, 109–110

F

Face peeling, 13

First aid management, 114–115

G

Glucose, 30, 31

Glutathione system, 86–88

Guy de Chauliac, 2

H

Hexafluorine®, 38, 70, 87, 90, 114 Hippocrates Heraclidae, 3

History, of chemical burns and relative treatments, 3–4 eye burns, classification of, 6

Guy de Chauliac, 2 Hippocrates Heraclidae, 3

intensive care revolution, thermal burns and, 4–5 Marcel Legrain, 4

medical treatment, 6 origins, 5–6 reconstitutive concepts, 7 rinsing therapy, 6

skin burns, 5

toxicology and ophthalmology, research in, 6 treatment options, 7

Hydrofluoric acid (HF), 21, 28 burn mechanism, 33 decontamination, 87, 89–90 eye burns with, 70

pH, 26, 27 reactivity of, 23 rinsing therapy

decontamination, 87, 89–90 diffusion, 78

Hypertonic, 46, 56, 114

I

Inflammatory mediators

dose response SLS IL-8 from SM, 72, 73 eye burn model, 72

interleukin-8, 72 VEGF

NaOH corneal exposure, 72–73 SLS corneal exposure, 73–74

Innervation, 55 Intraocular lesions, 98–99 Intraocular pressure, 57

Irrigation fluids, rinsing therapy effect of

anterior chamber pH, 83 buffer capacity, 84

electrolytic contents, comparison of, 83 intracameral pH after corneal rinsing, 85 L929 cell, 85–86

types of, 82 Irritant/corrosive chemicals

molecular structure of, 18–19 reactive functional groups

acidic function, 19 alkylation reaction, 21–22 basic function, 19

chelating function/complexation, 21 molecular reactivity and chemical bonds, 22 oxidizing function, 19–20

reduction function, 20 solvent function, 20–21

K

Keratocytes, 52–53 Keratoplasty

with architectonic goal, 109 lamellar keratoplasty, 108–109

transfixion keratoplasty (TK), 106–108 Keratoprosthesis, 109

L

Lacrymal secretion, 49–50 Lacrymal, 113, 114

L929 cells, irrigation fluids effect, 85, 86 Limbal stem cells (LSC), 105

Limbus

corneal regenaration, 56

epithelial cells, transplantation, 109 histology, 54–55

transplantation allograft, 106 autograft, 105

conjunctival pannus, exeresis of, 105 Lipids, 30, 31

Liquid metal burns, 67

M

Marcel Legrain, 4

Methylamines series, 24

N

Nasal mucosa transplantation, 104–105 National Poison Data System (NDPS), 10 Necrotic tissues, debridement/excision, 103

O

Ocular anatomy and physiology, 93–94 Ocular hypertonia, 101

Osmolar effect, 78–82 Osmolarity

effects, rinsing therapy, 78–82 eye burns pathophysiology, 70–71

Oxidizing function, 19–20

P

Passive washing, 43–44 Pathophysiology, of eye burns

cellular survival, 71

corneal burns, mechanisms of, 66–70 inflammatory mediators, 72–74 osmolarity, 70–71

penetration characteristics, 71 physiological barriers, 59

Perilimbal ischemia, 94–96 Peroxides, 68–70

Phenol, 23–24

Plum, 83, 84, 90 Pressure, 43 Proteins, 30, 31

buffer, 60 Proteoglycans, 55

R

Reactive functional groups, irritant/corrosive agents acidic function, 19

alkylation reaction, 21–22 basic function, 19

chelating function/complexation, 21 molecular reactivity and chemical bonds, 22 oxidizing function, 19–20

reduction function, 20 solvent function, 20–21

Reduction function, corrosive agents, 20 Ringler, 81, 83, 84

Rinsing therapy development, issues in, 91

diffusion, mechanisms of, 78 glutathione system, 86–88 history, 6

hydrofluoric acid decontamination, 87, 89–90 irrigation fluids, effect of

anterior chamber buffer capacity, 84

electrolytic contents, comparison of, 83 intracameral pH after corneal rinsing, 85 L929 cell, exposure of, 85, 86

osmolar effects in blown-up cells, 81 corneal stroma, 79 corneal swelling, 82

cytolysis and necrosis, 120 s of exposure with, 81 Diphoterine®, 82

irrigation fluids, types of, 82

tissue culture, with 800 mOsmol (NaCl), 81 water contents of, 80

side effects of

corneal calcifications, 90 scratched cornea, 90

S

Safety obligations, 116–117 Sodium lauryl sulfate (SLS), 72–74 Solvent function, 20–21

Stem cell, 71, 91, 95, 96, 98, 100, 104, 105, 109 Stroma, 59, 78-80, 97, 107-109

collagen lamellae, 53 corneal regeneration, 57 ground substance, 53 keratocytes, 52–53 scarcity of cells in, 55 Schwann cells, 53

Sulfuric acid, 39, 40 Superficial cells, 50–51

Supernatant rinsing medium (SM), 72–74 Surgical treatment

of eyelid burns

in critical phase, 110

in sequelar phase, 110 keratoprosthesis, 109 lamellar keratoplasty (LK)

big diameter, 108–109 deep, 108

necrotic tissues, debridement/excision of, 103 symblepharons formation, prevention of, 103 Tenon’s plastics, 103–104

transfixion keratoplasty (TK) big diameter, 106–107 usual diameter, 107–108

transplantation

amniotic membrane, 106

buccal and nasal mucosa, 104–105 conjunctival, 104

cultivated limbal epithelial cells, 109 limbus, 105–106

Symblepharons, 12, 98, 100, 101, 103, 104, 106

T

Tear fluid, 61 Temperature, 42–43 Tenon’s, 55, 103–105 Tenon’s plastics, 103–104 Thermal eye burns, 67

Tissue culture, in rinsing therapy with Diphoterine®, 82

with 800 mOsmol (NaCl), 81 Titanium tetrachloride, 36–37 Transplantation

amniotic membrane, 106

buccal and nasal mucosa, 104–105 conjunctival, 104

cultivated limbal epithelial cells, 109 limbus, 105–106

Trichloromethylsilane, 37

U

US Bureau of Labor Statistics, 10

V

Vascularization, 55

Vinegar, 22–23

Viscosity, 35–36

W

Work-related injury, 11