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Cicatricial, postburn ectropion and exposure keratitis
I P Astori1, M J Muller, S P Pegg
1Royal Brisbane Hospital, Herston, Australia.
Summary
Facial burns can cause eyelid ectropion, leading to exposure keratitis and potential blindness. Early surgical release of eyelid ectropion is crucial to prevent severe eye injury in burn patients.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Burn Management
Background:
- Facial burns can result in eyelid ectropion, a condition where the eyelid turns outward.
- Ectropion can lead to chronic corneal exposure, increasing the risk of infectious keratitis, corneal perforation, and vision loss.
- Diagnosing ectropion in unconscious burn patients presents a significant clinical challenge.
Observation:
- Five patients with postburn eyelid ectropion underwent surgical release of 11 eyelids within 30-50 days postburn.
- Full-thickness skin grafts were successfully used for lower eyelid reconstruction without failure.
- One patient required a repeat surgical release procedure.
Findings:
- All patients presented with exposure keratitis upon ophthalmological evaluation.
- Temporary measures like plastic wrap were used to maintain corneal hydration pre-surgery.
- Patients with extensive facial burns requiring intensive care were identified as high-risk.
Implications:
- Prompt diagnosis and surgical correction of eyelid ectropion are vital in burn management.
- Early intervention can prevent sight-threatening complications such as blindness and disfigurement.
- This highlights the importance of vigilant ophthalmological monitoring in severe burn cases.