Primary care of ocular emergencies. 2. Thermal, chemical, and nontraumatic eye injuries.

First- and second-degree flash burns can be treated by the primary care physician, but third-degree burns will require a specialist for extensive debridement and skin grafting. Actinic keratitis, often associated with welding and snow skiing, is painful but can be treated with drugs in the office. There is no treatment for eclipse burn. Alkali is more toxic to the eye than is acid and can dill corneal epithelium and endothelium. All chemical burns require copious irrigation, but a patient with an alkali burn must be sent immediately thereafter to an ophthalmic surgeion. Acute glaucoma and acute occlusion of the central retinal artery are the two major nontraumatic eye emergencies. Patients with either of these injuries should be referred to a specialist after emergency measures have been taken.