The chemically injured eye.

Chemical injury of the eye may occur in a wide range of circumstances. Of first importance is the recognition of the nature of the injury since an increasing number of toxic substances is being used in home and industry and each type of compound may produce unusual corneal and conjunctival changes. Early assessment of the severity of the corneal burn helps determine prognosis and directs treatment. The use of topical sodium ascorbate and citrate has added new prospects of reduced corneal damage while enzyme inhibitors have shown some value in preventing and controlling corneal melting. The later problems of recurrent or persistent epithelial defects require careful manipulation of the tear film and corneal environment including the use of therapeutic soft contact lenses. In the long term, attention to the whole corneal environment, especially lids, conjunctiva, and tears, becomes most important especially in selection of patients for keratoplasty and in management of the complications which may follow surgery.