POOR-PROGNOSIS OF SEVERE CHEMICAL AND THERMAL EYE BURNS - THE NEED FOR ADEQUATE EMERGENCY CARE AND PRIMARY PREVENTION

The epidemiology and wound healing following medical and surgical trea tment of 101 patients with 131 severely burnt eyes due to chemical or thermal agents have been analyzed. Most of the accidents occurred at w ork (72.3%); the majority of the burns were chemical (84.2%), of which 79.8% were caused by alkalis. The long average duration of treatment on ward (5.2 +/- 4.1 months) and the high number of surgical intervent ions (8.0 +/- 8.0) indicate the difficulties in treatment and the dela yed recovery of the affected eyes. Despite improved possibilities of i mmune-suppression after keratoplasty (cyclosporin A) and new methods o f surgery (Tenon plasty), the possibilities of an optical rehabilitati on are still limited. A visual acuity of 6/60 or better was achieved i n 39 eyes (32.2%). Immediate irrigation was reported in 56.1% of accid ents at the place of work and in 42.8% of accidents sustained at home. There was a significant difference with respect to the extent of dama ge, the treatment on ward and the number of surgical interventions. Th e visual prognosis for eyes which received immediate irrigation was si gnificantly improved. Eye protection was not used in any of the 101 ca ses. Spread of information is necessary for adequate emergency care fo r eye burns as well as for permanent employment of protective glasses in highrisk occupations.