Ocular chemical injuries vary in severity, with the more severe end of the spectrum having profound visual consequences and medicolegal implications. Grading of ocular injuries is critical for determining acute treatment and visual prognosis. Poor immediate management results in more challenging treatment of acute disease. Similarly, poorly controlled acute disease results in more treatment-resistant chronic ocular disease. Despite several decades of research and public health initiatives, simple and effective interventions such as wearing protective eyewear and immediate irrigation of eyes remain as key challenges. Education and prevention are therefore important public health messages. Hurdles in the acute management of disease include poor evidence-base for commonly used treatments (e.g. based on experimental animal studies), reduced treatment adherence rates and high clinic non-attendance rates. The evolution of treatment strategies, particularly limbal stem cell transplantation, has revolutionised the visual and cosmetic outcomes in chronic phases of disease. It is therefore increasingly important to consider tertiary referral for patients with limbal stem cell failure or vision-limiting corneal scarring.
眼部化学性烧伤的发生严重程度不同, 其中较严重的眼化学性烧伤对视力预后和法医学影响意义更大。针对眼部化学性烧伤进行分期对于进行急救治疗和视力预后至关重要。在眼化学性烧伤急性期如果未及时处理会导致治疗更具挑战性。同样, 对于眼化学性烧伤急性期未进行有效地治疗会导致更多的难治性远期并发症的发生。尽管已经开展了几十年的临床与眼部健康的管理工作, 佩戴防护眼镜与眼部立即冲洗等简单有效的干预措施仍然是一项挑战。因此, 教育和预防是公共健康的关键。对于眼化学性烧伤急性期管理方面的阻力包括缺乏常规治疗的循证医学证据(例如基于实验动物的研究)、治疗的依从性低和门诊未就诊率高。随着治疗策略的更新, 特别是角膜缘干细胞移植的开展, 已经彻底改变了眼化学性烧伤慢性期的视力预后和眼部美观。因此, 对于患有角膜缘干细胞治疗失败或由于角膜瘢痕视力低下的患者, 考虑三级转诊变得越来越重要。