June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Ocular Signs Portending Surgical Intervention in Patients with Thermal Burns
Author Affiliations & Notes
  • Elisabeth Sledz
    Ophthalmology, Loyola University Health System, Maywood, Illinois, United States
  • Taylor Starnes
    Ophthalmology, Loyola University Health System, Maywood, Illinois, United States
  • Footnotes
    Commercial Relationships   Elisabeth Sledz None; Taylor Starnes None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4805. doi:
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      Elisabeth Sledz, Taylor Starnes; Ocular Signs Portending Surgical Intervention in Patients with Thermal Burns. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4805.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Although thermal ocular injury may result in sight threatening complications, ocular involvement may appear to be minimal at initial presentation. Ocular sequelae including corneal ulceration, eyelid deformities, exposure keratopathy, and ocular compartment syndrome do not always present immediately. Although many studies have reported the epidemiology of ocular thermal injury, a protocol for the timing and specific surgical intervention is currently unavailable. To reduce the incidence of sight-threatening complications of thermal burns we stratify the presenting symptoms, progression, and timing of intervention of ocular surface complications.

Methods : A retrospective chart review was performed from February 2022 to August 2022 at a regional burn center at Loyola University Medical Center (LUMC) that analyzed the timing of presentation after burn injury, initial symptoms at presentation and subsequent timing of medical and surgical interventions. Patients were identified using ICD-9 and ICD-10 codes indicative of thermal burns affecting the head, face, and eyes. Exclusion criteria included a history of severe ocular surface disease prior to thermal burn affecting the eyes, concomitant chemical burns, or mechanical trauma affecting the eyes or periocular skin.

Results : Of the 82 patients initially identified, 36 met the inclusion criteria.The minimum age was 9 years-old and maximum age was 77 with an average age of 45.6. Sixteen patients were male and 20 were female. The median time between ophthalmology consultation and first surgery was 10.5 days. 37 patients required ophtlamic surgical intervention. The most common first surgical intervention was tarsorrhaphy (44%). Other surgical interventions included skin graft, ectropion repair, corneal transplant, and amniotic membrane transplant. Greater than 20/40 vision was maintained in 63.1% of patients at one year. The most common long-term complications were corneal scarring (13.3%), exposure keratopathy (12.2%), lagophthalmos (11.2%), and corneal ulcer (10.2%).

Conclusions : Ocular thermal burns can have devastating ocular sequelae, but management protocols have not been optimized. We found a high rate of ocular surface complications following facial burns, many of which required surgical intervention. We were able to maintain vision >20/40 in around 60% of patients at one year. Future studies are recommended to help standardize a protocol for ocular thermal burns

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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