Pseudomonas ulceration of the cornea following major total body burn: a clinical study.

If periorbital or facial areas are involved in burn injury, the eyes must be given prophylactic care. The importance of these cases is not to point out the danger of corneal injury as a direct result of thermal trauma; rather, it is to emphasize the seriousness of corneal abrasions and the danger of subsequent Pseudomonas infection during convalescence of the postburn patient. Once the corneal epithelium is damaged, ulceration rapidly occurs and when infected with Pseudomonas aeruginosa presents one of the most difficult ophthalmologic situations. The convalescent burn patient is in jeopardy of corneal abrasion during general anesthesia for grafting or debridement. Neither of the patients who underwent anesthesia was noted to have corneal abrasion. Nor did either ectropion or lid contracture develop in the three patients described herein. Lid contracture may lead to corneal exposure and should be corrected by expeditious lid tarsorrhaphy. Once ulceration has occurred, as with these patients, corneal transplantation may be indicated.