In traumatology, a burn is understood as acute injury to the outer shells of the body by aggressive environments: high or low temperature, acid or alkali, solar or other wave radiation, etc.
Of all ophthalmic injuries, corneal burns occur in 15% of patients.
. Most of them are obtained in production, and only a third - in everyday life. By their specificity, they belong to the category of severe injuries requiring urgent assistance. In addition to the danger of irreversible changes in the tissue of the eyeball, burns are fraught with intense pain shock, which negatively affects the functions of vital organs.
Causes
The most common causes of burns to the outer shell of the eye, adjacent skin of the eyelids, tear ducts and glands, as well as deep-seated structures, are contacts with chemicals. Such an effect in ophthalmology refers to chemical burns of the cornea and is divided into several subtypes depending on what substance got on the cornea:
- Alkali burn. Occurs when a solution or dust of caustic soda, slaked lime or fluffed lime, a solution or vapor of ammonia, ethyl alcohol and drugs based on it, or household chlorine-based bleaches come into contact with the cornea. With this type of damage, liquefaction necrosis of the eye shell occurs, the area of which is much larger than the size of the contact spot: if a drop of the reagent gets on the eye, the burn itself will be 3-7 times larger than the diameter of this drop.
- Acid burn. Occurs when the membranes of the eye come into contact with vapors or solutions of vinegar, sulfuric or hydrochloric acid. This type of damage is accompanied by the formation of a scab - a focus of coagulative tissue necrosis, the boundaries of which rarely extend beyond the diameter of the contact spot.
- Thermal burn. It can occur when the eye comes into contact with hot liquid, hot steam, metal, grease, open flame, etc. In modern realities, thermal burns are often a consequence of improper use of electrical appliances, playing with firecrackers, etc. The nature of this type of damage is the same as as in contact with acids.
- Radiation burn. Occurs due to exposure of the cornea to ionizing, infrared or ultraviolet radiation. They are similar in nature to regular thermal burns, but can be deeper.
According to statistics, the basis of any corneal burn is non-compliance with standard safety measures when using household or professional chemicals or working with potentially hazardous objects.
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Varieties
The classification of thermal, radiation and chemical burns of the cornea of the eye divides the injury according to the degree of tissue damage, localization of the lesion and stage of the pathological process. In accordance with this, there are 4 degrees of burns of the cornea of the eye:
- Mild, or I degree
- superficial damage, accompanied by slight redness of the conjunctiva and skin of the eyelids, slight erosion of the surface of the cornea, which is noticeable only after treating the eye with fluorescein. Does not require intensive therapy; as it heals, it disappears without a trace. Does not threaten vision loss.
- Average, or II degree
- is expressed by superficial necrosis of the mucous membranes of the eye and conjunctiva, their swelling, damage to the stroma and epithelial layer of the cornea. Grayish-turbid lesions on the surface of the eye and blisters on the skin of the eyelids are visually recorded. With this degree of damage, scarring is likely to form on the surface of the cornea, which leads to a partial decrease in visual acuity. - Severe, or grade III
, necrotic changes are observed throughout the conjunctiva and its underlying layers, including the sclera and cartilage of the eyelids. Its surface acquires a grayish-yellow color and a matte texture. With such a degree of burn, the cornea loses its transparency and dries out. Changes are observed on 50% or less of the surface of the eyeball. After the scab is rejected, scar defects form on the cornea, which significantly reduce visual acuity. - Particularly severe, or grade IV
, is the deepest necrosis with charring of the conjunctiva and sclera of the eye. With this degree of damage, the cornea becomes completely opaque, holes appear on it, and the internal structures of the eye also undergo changes. With this degree, the likelihood of complete loss of vision is very high.
Based on the localization and extent of the process, three types of corneal burns are distinguished:
- with damage to the conjunctival sac;
- with destruction of the eyeball;
- damage to the adnexal structures of the eye.
Depending on the stage of the pathological process, eye burns are divided into:
- early
- lasts up to 2 days and is accompanied by an increase in necrobiosis, that is, the spread of tissue necrosis due to the breakdown of proteins and polysaccharides; - medium
- lasts up to 3 weeks, accompanied by a violation of tissue trophism; - late
- last up to 3 months and are accompanied by multiple trophic disorders with a lack of oxygen in the cornea, however, against this background, restoration of nutrition of the cornea is planned; - scarring
- lasts from six months to several years, accompanied by increased synthesis of collagen and protein, restoration of corneal functions.
Important! The most favorable prognosis is for mild superficial injuries. Full restoration of visual acuity after them occurs after 12-24 months. Severe damage often results in permanent vision loss.
How much hydrogen peroxide should I give my dog?
As with anything, the dose of hydrogen peroxide for dogs differs in its weight.
Larger dogs need a higher dose. A London veterinary clinic gives advice on how much hydrogen peroxide a dog should vomit in each weight bracket.
We must keep in mind that this is not dangerous and should only be done in emergency situations that correspond to the situations we have outlined earlier.
Dosage recommendations should be followed as strictly as with any other treatment.
Too much hydrogen peroxide for dogs can cause him to vomit. This can easily lead to aspiration pneumonia.
This is why this method is only recommended when the dog has ingested something truly dangerous but not corrosive, such as xylitol (found in chewing gum) or theobromine (found in chocolate).
Both of these non-caustic poisons pose a serious threat to the life of dogs.
They are chemicals that the dog has no real means to fight and properly treat
It is important to take your dog to the vet even after cleaning
It is always possible that too much theobromine or xylitol has already entered your dogs system before vomiting begins.
Let's look at another use. We know this chemical has some antiseptic abilities, so how good is it for cleaning wounds?
Can you put hydrogen peroxide on a dog that is hurt?
Symptoms
Clinically, a corneal burn always manifests itself clearly and unambiguously: even without special knowledge, it is difficult to mistake it for another injury. The most striking symptoms of chemical and thermal burns are:
- acute, almost unbearable pain localized in the damaged eye and eyelid;
- reflex closure of the eyelids, photophobia;
- intense lacrimation (if the tear ducts are damaged, the sign may be absent);
- hyperemia of the skin, mucous membranes, conjunctiva;
- clouding of the cornea (noticeable with a severe burn).
Radiation damage may not be accompanied by unpleasant symptoms immediately after receiving it. Burning sensation, lacrimation, photophobia, hyperemia and photophobia appear after a few hours.
First aid
According to statistics, the degree and depth of damage to the cornea is influenced not by the type of traumatic impact, but by the duration of its contact with the surface of the eye. That is why everyone, without exception, needs to know basic first aid measures.
Important! A quick and correct reaction is especially important in cases where there is a thermal or chemical burn to the cornea of the eye.
What needs to be done to stop or reduce the influence of traumatic factors
:
- rinse the eye with a stream of cool, clean water, preferably saline, but regular tap water will do;
- remove foreign bodies from the surface of the eye, especially if they are hot metal particles (molten polymers should not be touched);
- Place a gel or ointment with an analgesic effect in the conjunctival sac to relieve pain and prevent the development of shock.
In the first hours after the patient’s admission to the hospital, doctors must rinse the lacrimal canals and remove foreign bodies embedded in the membrane of the eye. To prevent infection, chemically neutral antiseptic solutions are used to wash the eye.
Important! It is strictly forbidden to wash off chemical reagents from the surface of the eye with other chemicals, for example, acids and alkalis and vice versa, as this can lead to additional damage. Experts note that treating a combined corneal burn is many times more difficult than a specific type of burn.
Action tactics
If you have a minor domestic injury, you can figure out on your own how to properly treat the wound. First of all, it must be washed with soap. This must be done from the center to the outer edges. Otherwise, you can only make the situation worse by increasing the number of microbes in the middle. But if you just cut your finger with a clean, sharp knife, then you can skip this step.
After this, you can begin to disinfect the damaged area.
To do this, it is important to know how to treat the wound. So, the problem area must be filled with antiseptic
Hydrogen peroxide is considered the ideal option. By the way, it is highly undesirable to use cotton wool for any cuts. If its fibers get inside, it will be very difficult to get them out. And they will contribute to the development of infection. In this case, healing of the damaged area will be difficult. It is advisable to treat the edges of the wound with iodine solution. This will prevent the introduction of germs from adjacent areas of the skin. But pouring it inside the cut is strictly prohibited!
After this, the wound must be covered with a sterile napkin, which will need to be secured with a plaster or bandage. Please note that the bandage must be changed as it begins to get wet. The damaged area can be moistened with peroxide each time.
Treatment
Intensive treatment of any type of burn of the cornea begins immediately after the patient enters a medical facility. To begin with, instillation of scopolamine and atropine directly into the eye is prescribed. These drugs relieve pain and reduce the formation of adhesions between the cornea and conjunctiva.
On the first day, the process of tissue change under the influence of traumatic factors continues. It is impossible to stop it completely, so doctors will have to wait until the necrotic processes stabilize. At this stage, it is important to prevent infection of the eyeball and reduce the intensity of symptoms. For this use:
- ointments and drops
with tetracycline, ciprofloxacin or chloramphenicol; - local non-steroidal anti-inflammatory drugs
- Diclofenac or Ibuprofen; - substitutes for tear fluid
to prevent drying of the cornea.
After stabilization of the condition, rehabilitation treatment begins. In the absence of perforations of the membranes of the eye, conservative methods are limited:
- injections of antioxidant drugs (methylethylpyridinol);
- placing gel-like regenerating preparations (Solcoseryl or Deskpanthenol) behind the eyelid;
- instillation of antihypertensive solutions (Betaxolol or Dorzolamide) into the eyes.
If the corneal burn is deep, hormonal agents are prescribed, most often glucocorticoids in the form of solutions for injection into the eyeball or conjunctiva.
Surgical intervention is used for deep and widespread damage to the membranes and internal structures of the eye.
If the anterior chamber of the eye is affected, corneal paracentesis is performed, followed by chamber sanitation. In case of deep damage to the eyeball, the dead areas of the conjunctiva, cornea, and vitreous body are removed, after which plastic restoration of the removed tissue is carried out.
In the long-term period, patients may require plastic restoration of the eyelids: elimination of eversion and entropion, ptosis, trichiasis, correction of post-burn cataracts, lamellar keratoplasty, etc.
Instructions for use
Treatment of cats with hydrogen peroxide requires the owner to comply with the following principles of therapy:
If the animal’s skin was damaged more than 2 hours ago, then there is no point in using the drug.
- Use the substance no later than 2 hours after injury to the skin.
- It is good to secure the kitten in your arms so that it cannot resist. The assistance of a second person may be required.
- Do not use hydrogen peroxide for an extended period as cell death may occur.
When treating wounds
If the kitten is injured, it should be treated as soon as possible. The owner will need to arm himself with a cotton swab, which must be soaked in hydrogen peroxide. Then, using it, you need to carefully treat the damaged area of the skin. Veterinarians recommend applying a sterile bandage to the treated area to prevent the cat from licking the wound.
From parasites
After using this antiseptic, you can proceed to instilling the necessary drug into the animal’s ears.
If we are talking about ear mite therapy, the owner will need to act following the following algorithm of actions:
- It is good to restrain the cat so that it does not resist and cannot scratch the owner.
- Take cotton sponges and soak them in a 2% hydrogen peroxide solution.
- Carefully treat the ears.
- Use the medication prescribed by your veterinarian. To get rid of ear mites, ointments, creams, and drops are used.
In case of poisoning
If your kitten is diagnosed with poisoning, it may be necessary to induce vomiting. For these purposes, a 3% solution of the substance is used. For 2.5 kg of cat's body weight you will need to take 5 ml of hydrogen peroxide. The medication is drawn into a syringe without a needle and carefully poured into the oral cavity. The medication will need to be given every 10 minutes until at least 3 doses have been ingested.
It is important to administer the product carefully. First of all, you need to place the syringe behind the fangs and gently press the plunger
No more than 1 milliliter of hydrogen peroxide should drip onto the tongue. Then the owner will need to wait for the cat to swallow, and then pour in the next milliliter. It is strictly forbidden to administer the entire amount of the substance at once, since the cat may choke and the substance will end up in the lungs.
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