Curling Iron Burn of the Cornea

These photographs were taken 1Z\x hours after a 45-year-old woman accidentally dropped a hot curling iron onto her right eye while she was styling her bangs. The images show white coagulation of the superficial corneal epithelium, erythema of the lateral infraorbital area, and a transverse pale area of the superior eyelid. Severe pain occurred immediately after the injury. The vision in her right eye was partially obscured by the white coagulation.

Robert P. Blereau, MD, of Morgan City, La, treated the patient with levofloxacin ophthalmic drops, an eye patch, and an ice pack to the eye; mupirocin ointment was applied to the first- and second-degree burns, and oral hydrocodone was prescribed for the pain. At follow-up the next day, the right eye appeared completely normal, was asymptomatic, and did not stain with fluorescein dye. Other than moderate edema, the upper and lower eyelids were normal. The burn in the inferior orbital area had become tan. The eye healed well. The patient had normal vision and no sequelae.

Pseudomonas keratitis with subsequent blindness is a dreaded complication of any type of corneal injury. Because quinolone ophthalmic drops are much less likely to be toxic to the cornea than aminoglycoside drops, the former are preferred for prophylaxis in such injuries.

Visual acuity should always be measured after any eye injury. In patients such as this one, who have severe pain as a result of the injury, vision testing may be difficult to perform until the pain subsides. *