Chemical and thermal ocular burns: a review of causes, clinical features and management protocol

Figures & data

Table 1: Hughes’ classification,¹⁴ modified by Roper-Hall¹⁵

Grade	Corneal alteration	Limbal ischaemia	Prognosis
I	Epithelial damage. No corneal opacity	No ischaemia	Excellent
II	Oedematous cornea. The iris details are visible	Ischaemia less than half at limbus	Good
III	Total epithelial loss. Stromal oedema. The iris details are obscured	Ischaemia affects one third to half of all patients at limbus	Reserved
IV	Opaque. The iris or pupil is invisible	Ischaemia affects more than half of all patients at limbus	Poor

Table 2: Dua’s classification¹²

Grade	Analogue scale	Clinical findings	Conjunctival alteration (%)	Prognosis
I	0.0/0.0	0 clock hours of limbal involvement	0	Very good
II	0.1-3.0/1.0-29.9	≤ 3 clock hours of limbal involvement	≤ 30	Good
III	3.1-6.0/31.0-50.0	> 3–6 clock hours of limbal involvement	> 30–50	Good
IV	6.1-9.0/51.0-75.0	> 6–9 clock hours of limbal involvement	> 50−75	Good to reserved
V	9.1-11.9/75.1-99.9	> 9 < 12 clock hours of limbal involvement	> 75 < 100	Reserved to poor
VI	12.0/100.0	Total limbus (12 clock hours) involvement	Total conjunctiva (100%) involved	Very poor

Hughes WF. Alkali burns of the eye. Arch Ophthalmol. 1946;35:423–36.10.1001/archopht.1946.00890200430010

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Roper-Hall MJ. Thermal and chemical burns of the eye. Trans Ophthalmol Soc UK. 1965;85:631–46.

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Dua H, King AJ, Joseph A. A new classification of ocular surface burns. Br J Ophthalmol. 2001;85(11):1379–83.10.1136/bjo.85.11.1379

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