Retrospective study of alkali burns of the eye

This report examines the epidemiology, management and morbidity of 159 cases of alkali burns of the eye admitted to The Royal Victorian Eye and Ear Hospital from 1972 to 1981. It was intended to use this as a basis for future accurate assessment and management of this problem. Grading of burns on information provided within the histories was according to Hughes' classification as modified by Ballen. Aspects examined were type of alkali, nature of accident, treatment, complications and follow-up. Results showed that the majority of burns were grade 1 or 2; only a few grade 1 and slightly more grade 2 burn patients suffered any complications, and none of these resulted in loss of vision. All patients with grade 3 and 4 burns suffered severe complications. It would appear that grade 3 and 4 burns need a more specific and energetic plan of treatment. Lime was the most common agent, and the largest group involved comprised male workers who suffered injuries at work. On the basis of the findings of the study the following points are raised: (i) a protocol for future study is suggested; (ii) there is a need for a more discriminate use of EDTA; (iii) do grade 1 burns require hospital admission?; (iv) treatment of grade 3 and 4 burns is still unsatisfactory; (v) the public must be made aware of the existing dangers of alkali burns and their prevention.