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April 1946

ALKALI BURNS OF THE EYE: I. Review of the Literature and Summary of Present Knowledge

Arch Ophthalmol. 1946;35(4):423-449. doi:10.1001/archopht.1946.00890200430010

THE serious nature of alkali burns of the eye was first emphasized in 1813 by George Beer, who stated:

. . . extensive and intensive chemical injuries of the eye are produced by slaked and unslaked lime . . . often acting so destructively that the entire cornea is disintegrated and suddenly changed into a greyish pulp which can be washed away from the iris below with a brush. . . The effect of the mineral acids, if they are also as saturated, is rarely so destructive for the cornea as is unslaked lime.

Since then, these burns have been the subject of intensive study, and a number of papers have appeared on the pathologic and the chemical changes produced in the corneal stroma by alkalis. In regard to treatment there are two sharply conflicting schools of thought, one school advocating conservative treatment with irrigations, neutralizing agents, symptomatic therapy and, later, corrective surgical measures when indicated, while