Left ocular alkali injury: a case report

Abstract

Background: Chemical injury represents an ocular emergency caused by sudden exposure to high (alkalis) or low (acids) pH substances. Such cases often inflict on individuals at productive age, whom 70% of which are male. Approximately 63% of chemical injuries occur in industrial setting. Classification based on the degree of severity it caused is applied to determine appropriate management and prognosticate outcome. Signs and symptoms observed including pain, photophobia, decreased level of visual acuity, hyperemic conjunctiva, and elevated intraocular pressure (IOP).
Case: We describe an outpatient from Sanjiwani Gianyar General Hospital eye polyclinic in Agustus 2019. A 25-year-old woman presented with pain in the left eye after inadvertent caustic soda splash. Ophthalmic examination revealed conjunctival vascular injection (CVI) and pericorneal vascular injection (PCVI) along with positive fluorescein staining of the left eye. She was diagnosed with alkali-related chemical injury with complicating corneal erosion. Therapeutic measure instituted were ocular irrigation using Ringer’s lactate solution, oral and topical antibiotics, topical steroid, and oral analgesics. Her good prognosis should be ascertained with close follow-up.
Conclusion: The main principle of injury management is to remove offending agent and maintain ocular surface pH within normal limit.