Key Research Findings

• Epidemiology:

  • Large-scale studies in the US and UK indicate chemical eye burns remain a significant public health concern, with alkali agents responsible for the majority of severe cases.

  • Incidence rates are highest among working-age adults, particularly in occupational settings, and there is a noted rise in assault-related injuries.

• Classification Systems:

  • The Roper–Hall and Dua et al. classification systems are critically compared.

  • Recent prospective and retrospective studies suggest that the Dua system offers finer prognostic stratification for severe injuries, though both systems have limitations regarding conjunctival and injury depth assessment.

• Acute Management:

  • Immediate irrigation is supported by animal and human studies as the most effective intervention to reduce severity and improve outcomes.

  • The article highlights the Morgan lens as a device enabling continuous irrigation, referencing its clinical utility and availability.

  • Comparative studies of irrigation solutions (e.g., saline, Diphoterine®) show no clear superiority, emphasizing the importance of timely intervention over solution choice.

• Therapeutic Advances:

  • Anti-inflammatory agents, topical antibiotics, and adjunctive therapies (ascorbate, citrate, tetracyclines) are supported by experimental and clinical evidence for reducing complications.

  • Blood-derived topical therapies (autologous serum, umbilical cord serum) and amniotic membrane transplantation are discussed, with randomized controlled trials indicating benefits in epithelial healing for select cases.

• Chronic Complications and Surgical Interventions:

  • Limbal stem cell deficiency (LSCD) is a major sequela; recent studies demonstrate improved outcomes with autologous and allogeneic stem cell transplantation techniques.

  • Systematic reviews and long-term cohort studies report encouraging visual outcomes for keratolimbal allografts and cultivated limbal epithelial transplantation, though graft rejection remains a challenge.

• Prevention and Public Health:

  • Epidemiological data underscore the preventable nature of most injuries, advocating for enhanced workplace safety measures and public education.

Research Implications

• The article calls for further randomized clinical trials to refine irrigation protocols and evaluate emerging therapies.

• It highlights the need for improved classification systems that incorporate injury depth and conjunctival involvement.

• Data collection and longitudinal studies are recommended to better understand outcomes and optimize management strategies.