Table 2 Roper-Hall classification of chemical eye injury82 and recommended treatment
From: Management of corneal injuries in spaceflight and recommendations for planetary missions
Grade | Clinical findings | Limbus | Prognosis | Recommended treatment |
|---|---|---|---|---|
I | Corneal epithelial damage | No limbal ischemia | Good | -Topical antibiotic ointment (e.g., erythromycin) 4x/day -Prednisolone acetate 1% four times a day -Preservative free artificial tears prn -Short-acting cycloplegic (e.g., cyclopentolate) 3x/day for pain |
II | Corneal haze, iris details visible | <1/3 limbal ischemia | Good | -As grade I -Topical antibiotic (e.g., fluoroquinolone) 4x a day -Long-acting cycloplegic (e.g., atropine) -Oral vitamin C, 2 grams 4/day -Doxycycline 100 mg 2x/day -Sodium ascorbate drops (10%) hourly -Debridement of necrotic epithelium and application of tissue adhesive |
III | Total epithelial loss, stromal haze, iris details obscured | 1/3–½ limbal ischemia | Guarded | -As Grade II -Consider amniotic membrane transplant |
IV | Cornea opaque, iris and pupil obscured | >1/2 limbal ischemia | Poor | -As Grade II and III -Surgery; Tenonplasty may reestablish limbal vascularity; Amniotic membrane transplant |
