Ocular thermal burns can result from various factors. Contact thermal burns occur when high-temperature liquids such as molten iron, boiling water, or hot oil splash into the eyes, while flame burns are caused by direct exposure to fire. Burns from boiling water or oil are generally mild, presenting with erythema and blisters on the eyelids, conjunctival hyperemia and edema, and mild corneal opacity. Severe thermal burns, such as those caused by molten iron splashing into the eye, may lead to deep tissue damage in the eyelids, conjunctiva, cornea, and sclera, potentially progressing to tissue necrosis. Post-healing complications may include cicatricial ectropion, incomplete eyelid closure, corneal scarring, symblepharon, and even ocular atrophy.
Treatment
The primary objectives involve preventing infection, promoting wound healing, and averting complications such as symblepharon. For mild thermal burns, topical mydriatics and antibiotic eye drops are administered. In severe cases, necrotic tissue is debrided, with treatment protocols resembling those for severe alkali burns. Corneal necrosis may require amniotic membrane transplantation, limbal stem cell transplantation, or total lamellar keratoplasty with limbal epithelium. Late-stage management focuses on addressing complications according to clinical manifestations.