Mustard Gas Injuries to the Eyes

OUTLINE Incidence Dose necessary to produce lesion Course of severe corneal burns Action on tissue Local Action Liberation of hydrochloric acid Derivatives Whole molecule Tissue hypersensitivity Systemic Action Break-down products Metabolism Bone marrow Antibodies Changes secondary to burns Fundus changes Prophylaxis Treatment Patients without corneal involvement Reassurance Irrigations Bland solutions Hypertonic solutions Neutralizing agents Irrigating apparatus Dark glasses or eye shade Convalescence Patients with corneal involvement Immediate treatment Oily drops and ointments Ascorbic acid Secondary infections Mild silver protein and boric acid Antiseptics Sulfanilamide and derivatives Convalescence 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