Classification of Schrage et al for Chemical Burns of the Eye

Description

Schrage et al used a simple classification for the emergency handling of chemical burns to the eye. It is a modification of the scheme used by Reim. The authors are from the Aachen Augenklinik, Germany.

Types of injuries:

(1) alkali (about two thirds)

(2) acids (about one quarter)

(3) thermal burns (hot metals, fireworks, etc.)

(4) miscellaneous chemical agents

Parameters:

(1) epithelial erosions

(2) conjunctiva

(3) limbal ischemia/damage

(4) corneal damage

Erosions	Conjunctiva	Limbal Ischemia	Corneal Damage	Grade
absent	normal	none	none	0
present	hyperemia	1 - 33%	superficial	I
present	chemosis	34 - 50%	superficial	II
present	chemosis	51 - 75%	opacified	III
present	chemosis	> 75%	opacified with necrosis	IV

Grade	Complications	Prognosis
0	none	complete restitution
I	none	complete restitution
II	may have focal scarring	complete restitution with small scars
III	corneal damage, vascular proliferation	scarring; may require ophthalmologic surgery
IV	corneal ulcers, iris atrophy, retinal complications, glaucoma, loss of globe, blindness, cosmetic deformity	uncertain but may be poor, usually some degree of residual disability

Immediate and continued irrigation is essential, pending ophthalmologic management. Delayed irrigation may be associated with more severe damage and a worse prognosis.

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Description

Specialty

ICD-10