بنام خداوند بخشنده مهربان
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بنام خداوند بخشنده مهربان . Ocular thermal burns. Burns of the eyelid conjunctiva cornea sclera are considered ocular burns. Ocular burns classified by etiologic agents. Chemical injuries Radiant energy injuries heat Radiation . Pathophisiology. Severity depend on

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Ocular burns classified by etiologic agents
Ocular burns classified by etiologic agents ocular burns

  • Chemical injuries

  • Radiant energy injuries heat

    Radiation


Pathophisiology
Pathophisiology ocular burns

  • Severity depend on

    1- Exposure duration

    2- Causative agent


Burns damage tissue by
Burns damage tissue by ocular burns

1- Denaturing

2- Coagulating

Cellular proteins  causes vascular ischemic damage




The major concern with ocular burns is
The major concern with ocular burns ocular burns is :

1- Final visual acuity

2- Cosmetic appearance




Clinical findings
Clinical findings burns

  • Most commonly are superficial

  • Most commonly complain tearing

  • Photophobia and F.B. sensation

  • Corneal burns can occur with sparing of the eyelids because individuals may keep their eyes open as they try to escape of fire



First degree
First degree burns

1- Aactive congestion of superficial blood vessels ( erythema )

2- Erythema followed by epidermal desquamation ( peeling )

3- No sequela


Second degree
Second degree burns

1- Transudation of serum from the capillaries causes edema and vesicles and blebs

2- Complete recovery without scar formation


Third degree
third degree burns

1- Burns are serious

2- Full thickness of the skin is involved

3- Skin appendages are also destroyed

4- No epithelium for regeneration

5- Healing leaves scar


Fourth degree
Fourth degree burns

1- Burns distracted entire skin and subcutaneous fat and tendons

2- Both 3 & 4 degree burns need

grafting for closures


Management of ocular burns
Management of ocular burns burns

1- Immediate first aid for minor thermal burns consists of prompt cold application :

a: ice water

b: cold tap water

2- Vesicles or blebs should not be opened but should be protected from injury

Vesicles are a natural barrier against contamination

If the become tense and painful the fluid may be evacuated under strictly aseptic conditions by puncturing with a needle

Bacterial and fungal infection are a serious complication in sever burns


Human amniotic membrane
Human amniotic membrane burns

  • Consists of

    1- A thick collagen layer

    2- Basement membrane

    3- Epithelial layer


Human amniotic membrane1
Human amniotic membrane burns

1- Contain low antigen activity against body immune system

2- Contain antibacterial and anti inflammatory effects so it prevents from scar tissue formation

3- It prevents new vessels formation


Indications
Indications burns

1- Severe dry eye with stem cell graft

2- Ocular pemphigoid

3- Conjunctival flap in persistent corneal epithelial defects

4- Ptergium

5- After removal of tumors

6- Ocular burns

7- Symblepharon

8- Ocular surface disorders

9- In lid surgery

10- Peripheral ulcerative keratitis

11- In bulus keratitis


  • Human placenta was obtained under sterile conditions from planned cesarean section

  • After removal of adherent blood amniotic membrane was manually separated from the chorion

  • Pieces of 2.5 × 5 cm .sutured on to sterile carrier membrane

  • Carrier membrane is made of cellulose nitrate and should be keep in – 80 ْ of centigrade

  • Epithelium side is up

  • Amnio dry allow graft


نادر ترین پیوند – پیوند شب و شب بو این عطر و رنگ جاری – آن افسون تو در تو با اینکه بی شب بو - زشب چیزی نمی کاهد آیا چرا – بی شب زشب بو می گریزد بو



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