Periocular Facial Scald Burns in Children: Is Ophthalmology Consultation Necessary?

Objectives: Criteria that predict the need for ocular injury treatment in children who suffer periocular facial scald burns are not known. The purpose of this study was to evaluate the incidence and management of ocular injuries among children sustaining facial scald burns and to determine predictors of injuries requiring additional treatment.

Methods: Children treated at a burn center with periocular facial scald burns were analyzed. Patient and injury profiles were compared between those evaluated and not evaluated by an ophthalmologist. Factors associated with an ocular injury requiring treatment were determined, and treatment differences before and after ophthalmology consultation were evaluated.

Results: Seventy-three children with facial scald burns were identified, none with a full-thickness injury. Thirteen children had ocular findings on examination including corneal abrasion, conjunctivitis, scleral burn, and chemosis of the conjunctiva. Twenty-three patients received erythromycin ointment, only 8 of whom had a documented ocular injury. Children seen by an ophthalmologist (n = 24) more often had a positive finding on examination (37.5% vs 8.2%, P = 0.007) and received treatment (66.7% vs 14.3%, P < 0.001). Only 4 patients had modification in their treatment plan after consultation, 3 of whom were started on treatment despite not having a positive finding on examination.

Conclusions: Ocular injury after periocular facial scald burns is an infrequent finding. Among children with partial-thickness periocular facial scald burns, initial evaluation and treatment without ophthalmology consultation are appropriate. Ophthalmic antibiotic ointment is an appropriate initial treatment in most symptomatic patients, with ophthalmologic consultation being limited to children without symptomatic improvement.