Healing process of moderate-severe mustard gas burn to eyes
Casualty caused by bursting of “Yellow Cross” shell close to man, while he was riding a resistive mule, causing his box respirator to become momentarily displaced. Fine spray of liquid splashed lightly on right side, causing cutaneous blisters on right cheek, neck, forehead, and serious burning in right eye. Left eye showed only mild burning, with a short-term acute conjunctivitis.
In similar cases, infiltrated corneal ulcer with hypopyon and secondary infection are both serious concerns. This case healed slowly but unremarkably.
Plate XIa: Severely burned eye in the acute stage - Early second day after mustard gas exposure. Eyelids and external surface of globe display intense inflammation, tears constantly produced behind edematous eyelids. Photophobia and blepharospasm at this point make examination difficult.
Plate XIb: Slightly later stage in acute burning - Swelling in conjunctiva and below has subsided, but solid white edema in the palpebral aperature is still well marked. The cornea is grey in the exposed region.
Plate XIIa: Stage of resolution after severe burning - Vascular injection is passing off, and solid edema is becoming absorbed. Corneal epithelium no longer cloudy. At this stage, atropine should be discontinued, but dark shades should be continued.
Plate XIIb: Late stage of resolution - Vascular injection above and below cornea practically disappeared, and the solid white edema is reabsorbed. The formerly red parts of the eye are now white, and the formerly white part of the eye is now red. Atropine and dark shades should not be used at this stage (which is also similar to mild burns), and use of eyes should be encouraged, with occupation (such as knitting, transcription, etc).
An Atlas of Gas Poisoning. Medical Research Council [Canada], 1918.