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Research Letter |

Outcomes of an Algorithmic Approach to Treating Mild Ocular Alkali Burns

Ahmad Al-Moujahed, MD1; James Chodosh, MD, MPH1
[+] Author Affiliations
1Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston
JAMA Ophthalmol. 2015;133(10):1214-1216. doi:10.1001/jamaophthalmol.2015.2302.
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This case series evaluates the results of following a clinical algorithm to treat mild ocular alkali burns.

Ocular alkali burns can cause corneal blindness. They typically occur in young males in accidents or assaults, and the most common agents include lye, ammonia, magnesium hydroxide, potassium hydroxide, and lime.1 Treatment indicated at the time of injury is irrigation to return the pH to normal,2 but the optimal care following pH normalization is less well defined and, to our knowledge, has not been studied in clinical trials. In 2013, we proposed a clinical algorithm for treatment of acute ocular alkali burns to standardize their treatment, specifically defining the use of topical corticosteroids, oral vitamin C, oral doxycycline, bandage contact lenses, and amniotic membrane (Figure).3 We now describe our initial results with this algorithm at the Massachusetts Eye and Ear Infirmary Emergency Department and show that the algorithm sped the time to restoration of best-corrected visual acuity following mild ocular alkali injuries.

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Algorithm for the Management of Acute Ocular Alkali Burn in the Emergency Setting

Adapted from Hamill et al.3

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