W. Va. Code R. § 85-20-33

Current through Register Vol. XLI, No. 24, June 14, 2024

Section 85-20-33 - Treatment Guidelines: Chemical Ocular Injuries

33.1. Chemical injuries may result from an almost infinite variety of agents contacting the ocular surface, with the extent of the injury largely a function of the nature of the substance involved, how much ocular surface is involved, and duration of exposure.

33.2. The appropriate diagnostic criteria is as follows: A detailed examination is performed after copious irrigation (see treatment). It is vitally important to know the chemical causing the injury, its concentration and amount of exposure.

In alkali burns, the Hughes classification (grading or corneal haziness and loss of blood vessels at limbus) is helpful in assessing long term prognosis.

33.3. The appropriate treatment is as follows:

a. Acute phase (0 to 7 days).

1. Immediate copious irrigation using any nontoxic irrigating solution;

2. Detailed ophthalmologic exam, including pH level of eye secretions;

3. Topical steroids, antibiotic drops, topical ascorbate and cycloplegic agents;

4. Follow-up outpatient for 3 weeks;

5. Immediate referral to ophthalmologist for alkaline burns; and

6. Monitoring for systemic effect of toxin.

b. Severe chemical injuries should be hospitalized for treatment for several days.

33.4. The estimated duration of care depends on the extent of the initial injury. Milder injuries may permit return to work after several days. Moderate chemical injuries (if bilateral) may need several weeks to recover. Severe burns (if bilateral) may be blinding. In many cases corneal transplants may be able to restore vision.

W. Va. Code R. § 85-20-33