Ocular Surface Damage

Understanding Eye Injuries Caused by Chemicals

Understanding Chemical Injury to the Eye: A Patient Guide

Chemical injury to the eye occurs when the eye comes into contact with harmful substances such as acids, alkalis, or other chemicals. These injuries can cause significant damage to the delicate structures of the eye, including the cornea, conjunctiva, and surrounding tissues. Here’s what you need to know

Types of
Chemical Injuries

Acid Burns

Caused by acids such as sulfuric acid or hydrochloric acid, resulting in coagulative necrosis and tissue destruction.

Alkali Burns

Caused by alkaline substances like lye or ammonia, leading to liquefactive necrosis and deeper tissue penetration.

Causes of Ocular Surface Chemical Injuries

Accidental exposure to household cleaning products, industrial chemicals, or environmental hazards.

Mishandling of chemicals during work or leisure activities.

Acts of violence or assault involving chemical substances.

Symptoms That May Indicate Chemical Eye Injury

Chemical exposure can cause sudden burning pain and intense discomfort immediately after contact with the eye.

The eye may appear extremely red due to irritation and inflammation of the ocular surface.

The eye often produces excessive tears as a protective response to wash out the chemical substance.

Chemical injury may temporarily or permanently affect vision depending on the severity of corneal damage.

Many patients experience discomfort while looking at bright light due to irritation and inflammation inside the eye.

Treatment For Chemical Injury

  • Emergency Eye Wash

    Immediately flush the eye with copious amounts of clean water to dilute and remove the chemical from the eye's surface. Thorough irrigation is crucial within the first few seconds to minutes after exposure.

  • Medical Evaluation

    Seek prompt medical attention from an eye care specialist, such as Dr. Arpit Shah, Cornea and External Eye Diseases Surgeon at Shriram Super Speciality Eye Hospital, for a comprehensive evaluation and treatment.

  • Medication

    Topical antibiotics, corticosteroids, and lubricating eye drops may be prescribed to prevent infection, reduce inflammation, and promote healing.

  • Amniotic Membrane Transplantation

    In severe cases of chemical injury, amniotic membrane transplantation (AMT) may be performed. The amniotic membrane, obtained from the placenta, is used as a biological bandage to promote tissue repair, reduce inflammation, and prevent scarring.

Amniotic Membrane Transplantation (AMT) Surgery

What is Amniotic Membrane Transplantation?

Amniotic membrane transplantation (AMT) is a surgical procedure that involves the use of the amniotic membrane (the innermost layer of the placenta) to repair or regenerate the ocular surface. The amniotic membrane has unique properties that make it ideal for this purpose: it is anti-inflammatory, anti-fibrotic, anti-scarring, and promotes epithelial healing. It is used in various ophthalmic conditions to enhance wound healing and reduce inflammation.

Indications for AMT in Eye Surgery

AMT is indicated in several ocular conditions, particularly those involving the cornea and conjunctiva. These include

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

To manage acute stages and support ocular surface healing.

Symblepharon Formation

To prevent or treat adhesion between the eyelid and the eyeball.

 
Conjunctival Surface Reconstruction

For reconstructing the conjunctival surface in cases of scarring or cicatrization.

Corneal Perforations and Descemetocele

To provide tectonic support and promote healing.

Limbal Stem Cell Deficiency

As part of treatments for limbal stem cell deficiency, such as SLET (Simple Limbal Epithelial Transplantation).

Chemical Burns

To promote healing and reduce inflammation in cases of chemical injury to the eye.

Thermal Burns

To manage and heal the ocular surface after burns caused by heat.

Corneal Ulcers

Particularly those that are refractory to conventional treatments, to aid in healing and prevent perforation.

Persistent Epithelial Defects

When the corneal epithelium fails to heal on its own, AMT can facilitate closure.

Pterygium Surgery

To reduce recurrence and enhance healing after the surgical removal of a pterygium.

Procedure

The procedure for AMT involves several key steps

  • Preparation

    The eye is prepared and anesthetized using topical or local anesthesia.

  • Harvesting the Amniotic Membrane

    The amniotic membrane is sourced from a placenta donated after cesarean section. It is thoroughly screened for infectious diseases and preserved until use.

  • Placement

    The amniotic membrane is carefully trimmed to the required size and shape. It is then placed on the affected area of the eye, with the epithelial side up, facing the ocular surface.

  • Securing the Membrane

    The membrane is secured in place using sutures, fibrin glue, or both. In some cases, a bandage contact lens is placed over the membrane to protect it and enhance patient comfort.

  • Postoperative Care

    Patients are typically prescribed topical antibiotics, corticosteroids, and lubricants to prevent infection, control inflammation, and keep the ocular surface moist.

Advantages of AMT

Promotes Healing

The amniotic membrane provides a scaffold that supports cell growth and tissue regeneration.

Prevents Fibrosis

By reducing fibrosis, AMT helps maintain the clarity and function of the cornea and conjunctiva.

Reduces Inflammation

Its anti-inflammatory properties help manage inflammation and reduce scarring.

Biocompatibility

The membrane is safe for use on the eye surface and is usually comfortable for patients during the healing process.

Conclusion

Amniotic membrane transplantation is a versatile and effective surgical technique for treating various ocular surface disorders. It offers significant benefits in terms of promoting healing, reducing inflammation, and preventing scarring. If you have any ocular surface conditions that might benefit from AMT, please consult Dr. Arpit Shah at Shriram Super Speciality Eye Hospital. Our experienced team is dedicated to providing advanced eye care solutions and ensuring the best possible outcomes for our patients.

Simple Limbal Epithelial Transplantation (SLET) Surgery

What is SLET Surgery?

Simple Limbal Epithelial Transplantation (SLET) is a surgical technique used to treat limbal stem cell deficiency (LSCD). The limbus is the border area between the cornea and the sclera, and it contains stem cells essential for the regeneration and repair of the corneal epithelium. In LSCD, these stem cells are damaged or destroyed, leading to a range of ocular problems, including corneal opacity, neovascularization, and vision loss.

Indications for SLET Surgery

Procedure

SLET surgery involves the following steps

  • Donor Tissue Harvesting

    A small biopsy of limbal tissue (approximately 2 mm) is taken from the patient's healthy eye. If both eyes are affected, donor tissue may be obtained from a living related donor or a cadaveric source.

  • Recipient Eye Preparation

    The conjunctivalized or scarred corneal surface of the recipient eye is carefully removed to prepare the bed for the transplant.

  • Graft Preparation

    The harvested limbal tissue is divided into tiny pieces.

  • Graft Transplantation

    The small pieces of limbal tissue are distributed evenly over the prepared corneal surface. These pieces act as "seeds" of stem cells.

  • Amniotic Membrane Application

    An amniotic membrane is placed over the transplanted tissue fragments to provide a supportive environment for the stem cells to grow and proliferate. The amniotic membrane is secured with sutures or tissue adhesive.

  • Postoperative Care

    The eye is bandaged with a contact lens to protect the grafts and promote healing. Patients are prescribed topical antibiotics, anti-inflammatory medications, and sometimes immunosuppressive drugs to prevent rejection and infection.

Advantages of SLET Surgery

Minimally Invasive

Requires only a small biopsy of donor tissue, reducing the risk to the donor eye.

Effective for Unilateral LSCD

Particularly beneficial for patients with unilateral disease, as the healthy eye can serve as the donor.

Simple Technique

Does not require complex laboratory facilities or extended cultivation of stem cells.

High Success Rate

Demonstrated to be effective in restoring corneal clarity and improving vision in many cases.

Conclusion

SLET surgery is a promising and effective treatment for limbal stem cell deficiency, offering a simpler and less invasive alternative to other transplantation techniques. It leverages the patient’s own stem cells to promote healing and restore vision, making it a valuable option in the management of LSCD.

For more information or to schedule a consultation, please contact Dr. Arpit Shah at Shriram Super Speciality Eye Hospital. Our team of experts is dedicated to providing the highest quality eye care and advanced surgical treatments.

Dr. Arpit Shah's Expertise

Chemical injuries to the eye can have serious consequences and require immediate action. If you experience a chemical injury or have concerns about eye safety, seek prompt medical attention.

Dr. Arpit Shah is a leading cornea surgeon renowned for his expertise in managing ocular surface diseases, including chemical injuries to the eye. With a focus on preserving vision and restoring ocular health, Dr. Shah specialises in advanced treatments such as amniotic membrane transplantation and limbal stem cell transplantation. Patients trust Dr. Shah’s skill and dedication to providing personalised care and achieving optimal outcomes for ocular surface conditions.

Preventive Measures to Avoid Chemical Injury

Handle chemicals with caution and follow safety protocols, including wearing appropriate protective eyewear and gloves.

Store household cleaning products and chemicals out of reach of children and pets.

Avoid rubbing or touching the eyes with dirty hands or contaminated objects.

Immediately rinse the eye with water in case of accidental exposure to chemicals and seek medical attention promptly.

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