Management of Alkali Eye Injury

Alkali burns are more severe than acidic burns because of their rapid penetrating effect through the cornea. Alkali agents cause saponification of fatty acids in the cell membrane with subsequent destruction of mucopolysaccharides at the same time; they enhance the collagenolysis process causing tissue necrosis and perforation. On the other hand, acidic agents precipitate tissue protein in which they create a barrier to further ocular penetration; an exception to this is hydrofluoric acid1-3. Common causative agents in chemical eye injuries include1: acids such as sulfuric acid, bleach and refrigerants, hydrochloric acid, acetic acid and hydrofluoric acid; alkali, such as ammonia, lye; lime, plaster and mortar, potassium hydroxide and magnesium hydroxide.