Burns of the ocular adnexa

Ocular and periocular burns continue to be very complicated problems to manage clinically. Significant contributions have been made over the last year regarding the care and rehabilitation of the patient with this type of injury. N-acetylglucose aminidase activity in burned corneoscleral tissues may prove to be a good clinical indicator to assess the severity of ocular burns. Tenonplasty and split-thickness dermal grafts offer alternatives to conjunctival flaps when the latter is not practical or possible. Split-thickness dermal grafts are useful for treating persistent corneoscleral defects when an environment conducive to free grafts exists. Tenonplasty is a useful procedure in patients with persistent corneoscleral defects in whom no conjunctiva is available and a free graft is not advisable. Oversized soft contact lenses may prove useful in the care of the burn patient predisposed to forniceal foreshortening. An algorithm has been presented to aid in the management of the patient with periocular burns. High-density porous polyethylene can be successfully utilized in the reconstruction of the facial skeleton in burn patients. Useful guidelines have been proposed for the use of tissue expanders in the lower face and neck in pediatric burn patients.