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The Efficacy of Calcium Gluconate in Ocular Hydrofluoric Acid Burns

Author: Beiran, I : Miller, B : Bentur, Y

Journal: Hum-Exp-Toxicol. 1997 Apr; 16(4): 223-8

Abstract:

  1. Although calcium gluconate (CG) is recommended in the treatment of hydrofluoric acid (HF) eye burn its efficacy seems to be controversial, and controlled human or animal studies are limited. The study’s objective is to compare the efficacy of 1% CG and normal saline irrigation for the treatment of HF eye injury in animals.
  2. 0.05 ml 2% HF was instilled to anesthetized rabbit’s eyes. One minute later, four treatment groups were studies: (1) irrigation with normal saline followed by topical antibiotics, corticosteroids and cycloplegics for 48 h (n = 10); (2) irrigation with 1% CG followed by the same topical treatment (n = 9); (3) as group 1 and 1% CG drops over 48 h (n = 10); (4) as group 3, and injection of 1% CG subconjunctivally after irrigation (n = 9).
  3. Corneal erosion area, corneal haziness, conjunctival status, vascularization (pannus) and acidity were assessed before injury, immediately after initial treatment and 1, 2, 7 and 14 days thereafter by slit lamp aided by fluorescein staining.
  4. Conjunctival pH dropped from 6.0-6.5 to 2.5-3 after injury and increased to 6-6.5 after irrigation. Corneal erosion: smaller in groups 2, 3, significantly so at 2 days, but not different at 14 days. Corneal haziness: more severe in group 4, at 14 days, insignificant. Conjunctival damage: significantly worse in group 4 at 2, 7 and 14 days. Pannus appeared in 2-4 eyes in each group.

CONCLUSION: It seems that for HF injury 1% CG did not have any significant advantage over saline irrigation and topical treatment only. It might have some initial and temporary effect on healing process especially that involving erosion. Given subconjunctivally, 1% CG may be toxic and worsens clinical outcome.

While beginning to wear contact lenses, I had an experience which the use of the Morgan Lens saved the day.


I was just finishing a sixteen-hour shift as manager and staff nurse of the ED when I was notified that they had received a bomb threat.  Disaster situation were part of my duties, so I went into action.  By 4:00 AM, I realized I still had my contacts in.  So I got a container and soaked them in an eye solution from our eye tray.  I arrived home with enough time to take a quick nap before returning to work for another sixteen-hour shift.  When I put my contacts in, I felt like someone had placed a hot poker into my eyes.  I took the contacts out, but my eyes continued to burn and were also fire engine red.  I did report to work at 7:00 AM but my eyes continued to burn.  I then decided the best thing I could do was to irrigate, so I placed a Morgan lens into both eyes and irrigated with 1000 cc of lactated Ringer's.  Laying down during the irrigation process was relaxing and I felt no discomfort while my eyes were irrigated.  After the process, the burning was relieved and I was able to complete my shift without further discomfort.

Registered Nurse (South Carolina)

MorTan Inc.

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Why Use The Morgan Lens?

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.