Abstract
Chemical.
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Indications
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Chemical burns to the eye.
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Removal of superficial foreign bodies.
Contraindications
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For suspected globe perforation, extreme care must be taken to not exacerbate the injury.
Procedure
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1.
Informed consent is generally not required, although a thorough explanation to the patient is warranted.
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2.
Obtain pH of the eye before instilling anesthetic drops.
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3.
Anesthetize the eye(s) with topical anesthetic of choice by instilling drops within the lower lid and then asking the patient to blink several times in order to evenly distribute the solution.
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4.
Ensure there are no foreign bodies on the inside of the upper lids by inverting the upper lid.
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Particulate foreign bodies may be removed with moistened cotton tip applicators.
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5.
After adequate anesthesia is ensured, place one end of the Morgan lens within the fornix of the upper lid (Fig. 54.4).
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6.
Next, gently retracting the lower lid will ensure smooth placement of the remaining portion of the Morgan lens (Fig. 54.5).
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7.
Using the end of the Morgan lens, screw in the prepared IV tubing (Fig. 54.6).
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8.
Attach the end of the IV tubing to the saline bag, and place at height to allow for gravity to ensure a smooth flow of solution.
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Continue to irrigate the eye until desired pH is obtained.
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9.
To remove the Morgan lens, use the opposite technique for insertion.
Complications
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Corneal abrasions may be caused by the Morgan lens and are treated in the usual fashion.
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Deep corneal injury may occur with inadequate irrigation.
Pearls and Pitfalls
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Note that alkali burns will require significant irrigation and more topical anesthesia may be required.
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Ophthalmological consultation may be required, especially for alkaline and hydrofluoric acid burns.
Suggested Reading
Lang GK. Ophthalmology: a short textbook. Stuttgart: Thieme; 2000.
Rhee DJ, Pyfer MF, Rhee DM, editors. The Wills Eye manual: office and emergency room diagnosis and treatment of eye disease. third ed. Philadelphia: Lippincott Williams & Wilkins; 1999.
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Desai, B.K. (2022). Eye Irrigation. In: Ganti, L. (eds) Atlas of Emergency Medicine Procedures. Springer, Cham. https://doi.org/10.1007/978-3-030-85047-0_54
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DOI: https://doi.org/10.1007/978-3-030-85047-0_54
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