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Author: Kuckelkorn R, Schrage N, Keller G, Redbrake C. Department of Opgthalmology, Universitatsklinikum der RWTH Aachen, Germany.
Journal: Acta Ophthalmol Scand. 2002 Feb;80(1):4-10.
Abstract: Chemical and thermal eye burns account for a small but significant fraction of ocular trauma. The speed at which initial irrigation of the eye begins, has the greatest influence on the prognosis and outcome of eye burns. Water is commonly recommended as an irrigation fluid. However, water is hypotonic to the corneal stroma. The osmolarity gradient causes an increased water influx into the corneal structures. We therefore recommend higher osmolarities for the initial rinsing to mobilize water and the dissolved corrosives out of the burnt tissue. Universal systems such as amphoteric solutions, which have an unspecific binding with bases and acids, provide a convenient solution for emergency neutralisation. Both conservative anti-inflammatory therapy and early surgical intervention are important to reduce the inflammatory response of the burnt tissue. In most severe eye burns, tenonplasty re-establishes the conjunctival surface and limbal vascularity and prevents anterior segment necrosis.
Thanks for the opportunity to sing the praises of the Morgan Lens! Those of us who have been in the field for a while wonder what we ever did without them! We find two general uses for the lenses. One is for contact irritation: most typically, splashes. After local anesthetic, for ease of insertion, the lenses fit comfortably on patients of all ages and provide gentle and thorough irrigation of irritant substances. We have many cases of this type. The second most common use is for patients show suffer multiple injuries due to automobile accidents, major trauma, burns, falls, etc. Not only does the lens thoroughly irrigate the eye, removing most or all of the debris that has accumulated, it more importantly frees up the nurse's hands so that she can perform other lifesaving functions. Quite frankly, eye irrigation was treated as "the bottom of the list" often because other patient's other injuries were more devastating with higher morbidity and mortality. Particularly in the burn patient, the soothing effect of the irrigation and potential to prevent infection or further injury, make it an easy to use, valuable asset for patient care.Registered Nurse (Montana)
The Morgan Lens is used in 90% of hospital emergency departments in the USA and can be inserted in less than 20 seconds. There simply is no other "hands-free" method of eye irrigation. Nothing else frees medical personnel to treat other injuries or to transport the patient while irrigation is underway. Nothing is more effective at treating ocular chemical, thermal, and actinic burns or removing non-embedded foreign bodies, even when the patient's eyes are closed tightly. Its design makes it simple and straightforward to use so minimal training is required.