MUSTARD GAS INJURIES TO THE EYES

OUTLINE 

• Incidence

• Dose necessary to produce lesion

• Course of severe corneal burns

• Action on tissue

  1. Local Action

     1. Liberation of hydrochloric acid

     2. Derivatives

     3. Whole molecule

     4. Tissue hypersensitivity

  2. Systemic Action

     1. Break-down products

     2. Metabolism

     3. Bone marrow

     4. Antibodies

     5. Changes secondary to burns

     6. Fundus changes

• Prophylaxis

• Treatment

  1. Patients without corneal involvement

     1. Reassurance

     2. Irrigations Bland solutions Hypertonic solutions Neutralizing agents Irrigating apparatus

     3. Dark glasses or eye shade

     4. Convalescence

  2. Patients with corneal involvement

     1. Immediate treatment

     2. Oily drops and ointments

     3. Ascorbic acid

     4. Secondary infections Mild silver protein and boric acid Antiseptics Sulfanilamide and derivatives

     5. Convalescence

     6. Late treatment

• Summary of present treatment

I. INCIDENCE  The present treatment of mustard gas—dichlorodiethylsulfide, or ClCH₂CH₂)₂S—injuries to the eyes is largely derived from the methods developed during the first World War. The incidence of mustard gas injuries during that period, with the clinical and the pathologic characteristics, has been summarized in the "Official History of the War."¹