Ŋku ƒe Atikewo ƒe Dzobibi Sesẽ: Alkali vs Acid, Contact Lens Extraction, kple Aɖabaƒoƒo 30 ƒe Tsidede Anyigba¶

Atikewo ƒe sisi alo atikekui ƒe dodo ɖe ŋku dzi nye ŋkudɔ ƒe nudzɔdzɔ kpata ɖeka kolia si xɔa ɣeyiɣi geɖe wu le atikewɔwɔ me, afisi nusi dzɔna le sɛkɛnd 15 gbãtɔwo me le aƒeme alo le dɔwɔƒee afia nenye be amea ƒe ŋku nɔa ŋku dzi alo ŋkuagbãtɔ tegbee. To vovo na abi akpa gãtɔ siwo me nèzɔa mɔ yia kɔdzi gbã eye nèxɔa atike evelia la, le ŋku ƒe dzobibi si wotsɔ atike wɔe me la, ele be nàdze tsidede tsi alo dzetsi si me wodea tsii atraɖii gɔme le teƒea le sɛkɛnd ʋɛ aɖewo me HAFI nàlala dɔnɔdzikpɔʋu. Alkaline chemicals (such as drain cleaner, oven cleaner, wet cement, lime, plaster, ammonia, dishwashing pods, and automotive airbag powder) are especially devastating because they dissolve cell membrane fats (liquefactive necrosis via saponification) and eat straight through the cornea into the inside of the eyeball within minutes. Ne atike aɖe dze wò alo ame aɖe si te ɖe ŋuwò ŋu le ŋkua me la, dze tsilele gɔme enumake le tsiléƒe, tsileƒe, alo ŋkuklɔƒe si te ɖe ŋuwò esime ame bubu le ka ƒom na wò nutoa me ƒe xexlẽdzesi kpata to xexlẽdzesi siwo wozãna kpata. To aɖi kple ŋku ƒe mɔfiame siwo do ƒome kplii me le siminti, kɔnkrit xɔdzo, kple lime ƒe ŋkumekpɔkpɔ, . dzobibi sesẽwo kple atikewo ƒe tsilele, kple ŋku ƒe abixɔxɔ kple beléle kpata.

Wɔ esia fifia¶

1. Klɔ ŋkua Enumake kple tsi dzadzɛ si le sisim alo dze si me dɔlékui mele o le sɛkɛnd 10 me tso esime nèdoe. Mègatɔ be yeadi atike aɖe koŋ si tsia ŋkua nu o, mègalala kpekpeɖeŋunalawo o, eye mègagblẽ aɖabaƒoƒo ɖeka pɛ hã le ʋukuku yi kɔdzi kple atike ƒuƒu si bɔbɔ nɔ ŋkua dzi o. Zã ŋkuklɔƒe si le dɔwɔƒewo, tsifamɔ̃ si wotsɔna ƒua tsi le nuɖaƒe, tsileƒe ƒe tsileƒe, abɔ me tsiléƒe si ƒe nyaƒoɖeamenu le sue, alo tsinono si le aŋetu me fifia.
2. Lé ŋkume ƒe ŋkume ʋuʋu kple wò asibidɛwo eye nàkɔ ta la ale be ŋku si xɔ abi la nanɔ YIME kple axadzi (tsi sina tso ŋɔti ƒe tɔdzisasrã dzi yia gota yia to gbɔ). Ŋku si bi la hea ŋkume ƒe ʋuʋu sesẽ si woyɔna be reflex eyelid squeezing (blepharospasm); ne èkɔ tsi ɖe ŋkumeɖonu siwo wotu dzi la, tsi zero meɖoa ŋkume ƒe ŋkume o. Zã avɔ dzadzɛ alo pepa ƒe afɔkpa le wò asibidɛwo te be nàlée, he ŋkume ƒe akpa si le etame kple ete siaa ɖe wo nɔewo ŋu ɖe ŋkumeɖonu siwo ŋu ƒu le la ŋu, eye nàbia tso amesi ŋu wowɔ nuvevii la si be wòaʋuʋu eƒe ŋkumeʋuʋu atraɖii le go sia go me (dzi, anyi, miame, kple ɖusime) esime wòle tsi klɔm.
3. Ðe ŋkumeɖonu siwo wotsɔ dea ŋkume ne tsidedee dze egɔme ko. Lãmetsi falɛfalɛ wɔa dɔ abe aɖi si nye sponge kple numize si léa alkali alo acid si me wode nu me ɖe ŋkume ƒe ŋkume tẽe esime wòxea mɔ na tsidedee ƒe tsi be wòagaklɔ ŋkume ƒe ŋkume ƒe dzadzɛnyenye o. Klɔe sɛkɛnd 30 va ɖo 60 be wòaɖe ŋkumeɖonua, emegbe nàtsɔ ŋkumeɖonua aƒu gbe alo aƒoe enumake eye nàgadze ekɔklɔ atraɖii gɔme.
4. Na eteƒekpɔla aɖe naƒo ka na wò nutoa me xexlẽdzesi kpata esime nèyi edzi le tsi klɔm atraɖii aɖabaƒoƒo 30 ya teti (911 le United States kple Canada, 112 le Europa Dukɔwo ƒe Habɔbɔ bliboa me, 999 le United Kingdom; le United States la, àte ŋu aƒo ka na Poison Control hã le 1-800-222-1222 le nuƒomɔ̃ dzi). Mègadzudzɔ tsilele gbeɖe o vaseɖe esime dɔnɔdzikpɔʋua ƒe dɔwɔlawo naxɔ tsidedee atraɖii kple saline tubing si wodona ɖe ʋuka me alo Morgan Lens.
5. Klɔ ŋkume ƒe kotoku siwo le etame kple ete (conjunctival fornices) kple kotoklobo xɔdzo nenye be atike sesẽ, lime, plaster, siminti, alo nudzadzra ƒe atikekuiwo ge ɖe ŋkua me. Calcium hydroxide sesẽ (lime/cement) alo lye kristalowo gena ɖe ŋkume ƒe akpa si le etame kple ete la te goglo, afisi wonɔna abe atike si woɖena blewu ene bɔmb siwo le ƒoƒom gaƒoƒo geɖe esime tsi le sisim le ŋkume ƒe ŋgɔgbe gɔ̃ hã. He nutsyɔnu si le ete la yi anyime blewuu eye nàtrɔ nutsyɔnu si le etame la ɖe kotoku (eversion) dzi be nàtutu atike alo atikekui ƒe ʋeʋẽ ɖesiaɖe si woate ŋu akpɔ la ɖa.
6. Mègate kpɔ GBEÐE be yeatsɔ vinegar/lemon detsiƒonu alo acid dzodzoe kple baking soda "aɖe asi le eŋu" o. Acid kple gɔmeɖoanyi aɖe tsakatsaka le amegbetɔ ƒe ŋku ƒe anyime hea exothermic (dzoxɔxɔ-si ɖea go) atikewo ƒe dɔwɔwɔ ŋutasẽnuwɔwɔ vɛ si naa dzoxɔxɔ ƒe dzobibi sesẽ aɖe kpena ɖe atike ƒe dzobibi la tame, si gbãa ŋkume ƒe stroma si mebɔbɔ o la.
7. Tsɔ atike ƒe nugoe, dzesideŋkɔ, alo Dedienɔnɔ Ŋuti Nyatakakagbalẽvi (SDS) (alo ɖe nusiwo wotsɔ wɔe ƒe xexlẽdzesi si me kɔ le smartphone dzi) vɛ na atikewɔla si le xɔ si me wowɔa dɔ kpata le. Ne ènya atike ƒe ŋkɔ tututu kple eƒe pH la, egblɔna na kɔdzi ƒe ƒuƒoƒoa nenye be wole avu wɔm kple alkali ƒe gege ɖe eme goglo, hydrofluoric acid fluoride ƒe aɖi, alo cyanoacrylate superglue ƒe adhesion.

Nyametsotsoti: Atike kple dzoxɔxɔ ƒe ŋku ƒe dzobibi ƒe vovototodedeameme enumake kple tsidede wo me atraɖii¶

flowchart TD
    Start["Atikewo ƒe Tsi, Aŋe, Aerosol, alo Dzoxɔxɔ Si Wotsɔna Ƒua Ŋku"] --> CheckReactive{"Rare Dry Metal Exception Check: Ðe nusi wotsɔ wɔe nye Sodium, Potassium, Lithium metal, alo Calcium Oxide ƒuƒu (Quicklime) ƒuƒu si wotsɔ caked ɖe ŋkume?"}

    CheckReactive -->|"Ẽ: Elemental Alkali Metal ƒuƒu alo Quicklime Powder ƒuƒu sesẽ"| BrushFirst["1. Klɔ aŋɔ ƒuƒu le ŋkume/mo ŋu kple avɔ ƒuƒu alo swab hena sɛkɛnd 5 (Elemental Na/K wɔa dɔ kple tsi). 2. Na Quicklime le ŋku me: ƔEYIƔI tsiɖɔɖɔ kple tsi si le sisim ƒe agbɔsɔsɔ gã aɖe be wòaklɔ dzoxɔxɔ si le tsi me + tutu fornices."]

    CheckReactive -->|"AO: Alkali, Acid, Detergent, Solvent, Pepper Spray, alo Dzoxɔxɔ ƒe Dzobibi si wozãna ɖaa"| ImmediateFlush["DZEDZE TSI TSƆTSƆ GƆME LE SEKEND 10 ME: 1. Klɔ ta ale be ŋku si xɔ abi la nanɔ ÐE AME ME (sitso ŋɔti me yi to me). 2. Lé nutsyɔnuawo ɖe ƒu ƒe ʋuƒo ŋu. 3. Klɔe kple pɔmpi me tsi, dze si me dɔlékui mele o, alo Lactated Ringer’s ɣesiaɣi."]

    ImmediateFlush --> LensAndSweep["Le Aɖabaƒoƒo 1 ƒe Klɔƒe: 1. Ðe Contact Lenses ɖa enumake. 2. He nutsyɔnu si le ete la ɖe anyi & evert nutsyɔnu si le etame ɖe kotoku xɔdzo dzi be nàtutu siminti/lime/powder kristalo siwo xaxa la ɖa. 3. Yi edzi nànɔ tsi sisim madzudzɔmadzudzɔe hena >= miniti 30."]

    LensAndSweep --> EMSArrival["Ambulance & Emergency Department Care: 1. De Atike Siwo Wotsɔ Faa Alɔ̃e (Proparacaine / Tetracaine) si Wotsɔna Ða ŋkume be wòagbã ŋkume ƒe ʋuʋu. 2. De Morgan Lens si do ƒome kple Lactated Ringer ƒe Lita 1 va ɖo 3 la eme. 3. Zi eve-trɔ etame nutsyɔnu kple Desmarres retractor + EDTA chelation ne lime."]

    EMSArrival --> pHCheck{"Lala Aɖabaƒoƒo 5 Va ɖo 10 Le Tsidede Tsidede Nu Me Megbe, Emegbe Ka Asi Litmus Paper Ŋu Be Nàɖiɖi Ŋku ƒe Fornix: Ðe pH nye 7.0 va ɖo 7.4 pɛpɛpɛa?"}

    pHCheck -->|"AO: pH < 7.0 (Acidic) alo pH > 7.4 (Alkaline) ."| KeepFlushing["GADE TSI TSITSI GƆME ENƆME: Klɔ Lactated Ringer’s Lita 1 va ɖo 2 bubu eye nàgatutu fornices hena nu suesuesue siwo ɣla vaseɖe esime pH nali ke le 7.0 va ɖo 7.4 hena miniti 30."]

    pHCheck -->|"Ẽ: Neutral pH si li ke (7.0 va ɖo 7.4) ."| OphthoExam["Ŋkudɔléle Kpata Slit-Lamp & Roper-Hall / Dua Grading: Dze Topical Citrate, Ascorbate (Vitamin C), Doxycycline, Preservative-Free Steroids, Cycloplegics, & Amniotic Membrane gɔme ne esẽ."]

Dɔlélenutsiŋutete: Nusita alkali ƒe dzobibi gblẽa nu sã wu acid ƒe dzobibi¶

Ele be amesiame si kpɔa nudzɔdzɔ kpatawo gbɔ, dɔwɔƒedɔwɔla, kple dzila nase vovototo vevi si le nugbagbeŋutinunya me le alesi alkali (bases, \(\text{pH} > 7.0\), vevietɔ \(\text{pH } 11.5\text{ vaseɖe }14.0\)) kple acid (\(\text{pH} < 7.0\), vevietɔ \(\text{pH } 0\text{ to }2.5\)) dze amegbetɔ ƒe ŋkume ƒe lãkusi dzi:

1. Alkali Dzobibi: Liquefactive Necrosis kple Saponification (Ege ɖe eme Goglo le Sɛkɛndwo Me) .¶

hydroxyl ions (\(OH-\)) sɔ gbɔ ɖe atike siwo me alkali le me. Ne alkali aɖe ƒo aɖatsi ƒe film kple ŋkume ƒe lãkusi la, afɔku etɔ̃ dzɔna le ɣeyiɣi ɖeka me: - Lãmenugbagbeviwo ƒe Saponification: Hydroxyl ions wɔa nu kple ami ƒe ester kadodo siwo le ŋkume ƒe lãkusi ƒe lãmenugbagbeviwo ƒe lipid bilayers me tẽ, eye le nyateƒe me la, trɔa lãmenugbagbeviwo ƒe lãkusiwo wozua adzalẽ (saponification). Esi wònye be ŋkume ƒe gotagome mɔxenu si me tsi mate ŋu age ɖo o si kpɔa ame ta la lɔ̃na enumake ta la, alkali la doa go teteɖeanyi zero le eƒe gota. - Mucopolysaccharides kple Collagen ƒe nɔnɔmetɔtrɔ: Hydroxyl ions la blana ɖe ŋkume ƒe stromal glycosaminoglycans kple collagen fibrils ŋu, si wɔnɛ be wovuvuna, nɔa kpuie, wozua tsi, eye wozua tsi (liquefactive necrosis). - Nu Geɖe Kabakaba Yi Ŋgɔgbexɔa Me (Le Sɛkɛnd 15 Vaseɖe Aɖabaƒoƒo 3 Te): - Amonia (\(\text{NH}_3\) / \(\text{NH}_4\text{OH}\)) si wokpɔna le dɔwɔƒewo ƒe nufamɔ̃wo, agbledelawo ƒe amiwo, kple ahuhɔ̃e/anyigbadziklɔnu sesẽwo me la nye esi me ami le eye wòte ŋu ƒoa tsi hã; egena ɖe ŋkua ƒe ŋkume ƒe akpa bliboa katã yia ŋkua ƒe ŋku ƒe ŋgɔgbexɔ me le sɛkɛnd si mede 15 o me. - Sodium Hydroxide (\(\text{NaOH}\), lye) si le tsidzɔƒewo kple dzodoƒeklɔnuwo me gena ɖe ŋgɔgbexɔa me le aɖabaƒoƒo 1 va ɖo 3 me. - Potassium Hydroxide (\(\text{KOH}\)) si le button batriwo me kple caustic potash kple Calcium Hydroxide (\(\text{Ca(OH)}_2\), lime) si le kɔnkrit xɔdzo, aŋɔ, aŋɔ, kple aŋɔ ɣi me gena ɖe eme goglo esime wole calcium adzalẽ siwo me mekɔ o dam ɖe stroma la me. - Ŋku Ememe kple Limbal Stem Cells ƒe tsɔtsrɔ̃: Ne alkali la ge ɖe ŋgɔgbexɔa me ko la, edoa tsi si le eme ƒe pH ɖe dzi, egblẽa trabecular meshwork (si hea ŋkuʋuʋu enumake kple eƒe agbemeŋkekewo katã vɛ secondary glaucoma), ɖaa ciliary body (si hea hypotony kple phthisis bulbi, si nye ame kuku si shrunken vɛ ŋku), trɔa crystalline lens la wòzu opaque (chemical cataract), eye wòwua palisades of Vogt (limbal epithelial stem cells) le ŋkume ƒe nugbɔ.

2. Acid Dzobibi: Coagulative Necrosis (Protein Mɔxenu Si Seɖoƒe Ðo Ðe Eɖokui Ŋu) .¶

Atike siwo me aɖi le ɖea hayidrodzin ions (\(H+\)) ɖa esime woƒe anion ƒoa proteinwo: - Ne acid siwo bɔ wu (abe sulphuric acid si tso ʋu ƒe batri si me lead-acid le si le wowóm, hydrochloric/muriatic swimming pool acid, alo acetic acid) va dze ŋkua dzi la, haidrodzin ionawo trɔa protein siwo le ŋkume ƒe lãkusi si le etame la enumake eye wotsia wo me. - The Protective Scab Effect: Protein si le yame si ƒo ƒu ƒe ƒuƒoƒo sia trɔna zua ɣi si me mekɔ o abe azi ɣi si woɖa ene (coagulative necrosis), si wɔa dɔ abe ŋutilã me mɔxenu si me mekɔna o si xea mɔ na acid susɔea be wòagage ɖe ŋkume ƒe stroma alo ŋgɔgbexɔa me goglo o. - Ne ŋkume ƒe stroma kple limbal stem cells gakpɔtɔ le ete la, epithelial layer si ƒo ƒu la ƒuna eye wògatrɔna zua ŋkume ƒe ŋkumeʋuʋu si me kɔ le ŋkeke geɖe me. - ACID VEVI SIWO WOKPƆNA (Wɔa Nu Abe Alkalis): 1. Hydrofluoric Acid (\(\text{HF}\), si wokpɔna le ʋuwo ƒe aluminum tasiaɖamfɔwo ŋuti kɔklɔnuwo, gbeɖuɖɔ ɖeɖeɖanuwo, glass etching cream, kple kpewo ŋu kɔklɔnuwo me): Fluoride ion sue si me dzoxɔxɔ mele o (\(F-\)) metɔna to protein ƒe ʋuʋu le anyigba dzi me o; egena ɖe ŋkume ƒe ŋkume tẽ abe alkali sesẽ ene, ewɔa lãmenugbagbeviwo me calcium kple magnesium ƒe chelate, eye wònana ŋgɔgbexɔa me tsi (kpɔ hydrofluoric acid kple gbeɖuɖɔ ɖeɖeɖa ƒe dzobibi). 2. Heavy Concentrated Sulphuric (\(\text{H}_2\text{SO}_4\)), Nitric (\(\text{HNO}_3\)), alo Sulfurous (\(\text{H}_2\text{SO}_3\)) Acids: Dɔwɔƒewo ƒe tsidzadza siwo ƒe molarity lolo la naa dzoxɔxɔ sesẽ si me tsi le ne wodo ka kple aɖatsitsi eye wòɖua protein ƒe mɔxenu dzi.

Dɔdaƒewo tsɔtsɔ sɔ kple wo nɔewo nyuie: Aƒewo me kple dɔwɔƒewo ƒe ŋkumetike siwo bɔ¶

Afɔɖeɖe ɖesiaɖe ƒe mɔnu: Alesi woade tsi ŋku si fiã eye woatutu adzodalaawo¶

1. Tsidede Tsi Nyuitɔ Tiatia (Speed Beats Type Every Time) .¶

Ŋkudɔŋutinunya ƒe numekuku ɖo kpe edzi be sɛkɛnd 30 ƒe megbedede be woayi aɖadi saline ƒe aŋetu si me dɔlékui mele o gblẽa nu le ŋkume ƒe ŋkume ŋu wu sã wu tsilele le sɛkɛnd 5 me to pɔmpi me tsi dzro aɖe zazã me: - Tiatia Gbãtɔ (Le Kɔdzi alo Dɔnɔdzikpɔƒe): Lactated Ringer's (Hartmann ƒe Solution) alo Balanced Salt Solution (BSS). Esi wònye be Lactated Ringer ƒe (\(273\text{ mOsm/L}\), \(\text{pH } 6.5\)) ƒe osmolarity kple electrolyte ƒe dadasɔ te ɖe dzɔdzɔme amegbetɔ ƒe tsi ƒe nukokoedoname kple aɖatsi ŋu wu \(0.9\%\) Normal Saline ta la, tsidede aɖabaƒoƒo 30 va ɖo 60 didi kple Lactated Ringer’s nana ŋkume ƒe stromal dzi ɖena kpɔtɔna vuvu (edema) kple dɔnɔa ƒe vevesese si mebɔ o. - Amphoteric / Hypertonic Chelating Irrigants (Dɔwɔƒewo ƒe Kpekpeɖeŋu Gbãtɔ): Le afisiwo wodzra wo ɖo le Europa kple dɔwɔƒewo ƒe atikewɔƒewo la, Diphoterine alo Previn (hypertonic, polyvalent amphoteric chelating solutions) hea atike ions doa goe le ŋkume ƒe ŋkume le ɣeyiɣi ɖeka me to osmotic gradient me eye wòɖea acid kple base siaa ɖa dzoxɔxɔ ƒe dɔwɔwɔ manɔmee. - Le Aƒeme alo Dɔwɔƒe (Tiatia Enumake tso Sɛkɛnd 0 va ɖo 10): Klɔ pɔmpi me tsi si le sisim tso tsiléƒe, tsileƒe, tsidzɔƒe, alo tsigoe ɖesiaɖe me. Togbɔ be pɔmpi me tsi nye hypotonic (si nana ŋkume ƒe lãkusi vuvu vie kple tsi le aɖabaƒoƒo 30 ƒe tsilele me) hã la, eɖea hydroxyl alo hydrogen ion siwo gbãa ŋku la ɖa enumake eye wòklɔa wo ɖa. Mègahe tsidede pɔmpi me ɖe megbe sɛkɛnd ɖeka pɛ hã gbeɖe o.

2. Nukatae Ele be Akpɔkplɔwo Nado Enumake¶

Ne amesi ŋu wowɔ nuvevii do ŋkumeɖonu falɛfalɛ (hydrogel alo silicone hydrogel) alo esiwo sesẽ siwo me gas te ŋu gena ɖo: - Dzɔdzɔmeŋusẽ ƒe tsi ƒoa nu le ŋkumeɖonu la te to ʋukawo ƒe dɔwɔwɔ me le sɛkɛnd 1 me. - Emegbe ŋkumekpɔnu la wɔa dɔ abe tame si me tsi mate ŋu age ɖo o ɖe ŋkume ƒe ŋkumeʋuʋu dzi ene: àte ŋu akɔ tsi lita 10 ɖe ŋkumeɖonu la ƒe ŋgɔgbe aɖabaƒoƒo 30 esime pH 13 sodium hydroxide si me wode tsii la gakpɔtɔ le ŋkume ƒe ŋkume ƒe titina si le titina la ƒom. - Tsɔ kpe ɖe eŋu la, alkali siwo me pH sɔ gbɔ ɖo kple lãmenugbagbeviwo ƒe ʋeʋẽ lilili ƒoa polymer ƒe ŋkumeɖonu falɛfalɛwo, ɖea wo dzi kpɔtɔna, alo tsɔa atike ƒoa wo nu ƒu ɖe ŋkume ƒe ŋkume ƒe stroma si woɖe ɖa la dzi tẽ. - Removal Protocol: Dze tsilele gɔme enumake kple ŋkumeʋuʋu si wolé ɖe asi. Le tsi ƒe sisi sɛkɛnd 30 va ɖo 60 megbe (si dea ami ŋkumeɖonua ale be ehehe meɖea lãkusi si me gblẽ o ɖa) vɔ la, klɔ wò asibidɛwo kple tsi, tsɔ ŋkumeɖonu falɛfalɛa ƒu gbe ɖe anyime ɖe ŋkumeɖonu ɣia dzi, eye nàƒoe ado goe. Ne dɔnɔa le veve sem akpa be wòana nàka asi ŋkumeɖonua ŋu la, kpekpeɖeŋunalawo alo atikewɔla si kpɔa nudzɔdzɔ kpatawo gbɔ ade atike si wotsɔna fa alɔ̃e si wotsɔna ƒoa ŋkume (0.5% proparacaine alo tetracaine) 1 va ɖo 2 eye wòakɔ ŋkumeɖonua ɖa enumake.

3. Alesi Nàwɔ Evert Ŋkuwo Akpɔtɔ Atutu Conjunctival Fornices (Ele vevie na Lime, Cement, Kple Powders) .¶

Ŋku ƒe lãkusi wɔa kotoku goglo aɖe si toa ŋkume ƒe akpa si le ete (ŋku ƒe akpa si le ete) kple kotoku si goglo wu gɔ̃ hã, si woxatsa zi eve yi dzi le ŋkume ƒe akpa si le etame te (** ŋkume ƒe akpa si le etame**, si kekena milimeta 8 va ɖo 10 wu tarsal plate ƒe go si le etame). Ne kɔnkrit xɔdzo, aŋɔ, aŋɔ, gli ƒuƒu ƒe anyi, agblemenuku ƒe lime, tsi si kɔa tsi ŋu ƒe kristalo, alo nufamɔ̃ ƒe aŋe ƒo ɖe ŋkua me la, ʋuʋudedi si le keklẽm la ƒoa aŋɔ ɣi alo ɣi sesẽ aɖe ɖe kotoku mawo me goglo: 1. Klɔ Inferior Fornix: He ŋkume ƒe akpa si le ete la yi anyime tẽe ɖo ta ŋgonu esime nèle biabiam tso dɔnɔa si be wòafɔ mo dzi aɖo ta woƒe ŋkume. Zã kotoklobo-tipped applicator (cotton swab) si wotsɔ dze alo tsi ƒoe nàtsɔ aƒoe blewuu ahatutue tso gotagome dzogoea dzi va ɖo dzogoe ememetɔ dzi, nàkɔ lãgbalẽgolo ɣi alo aŋutiɖiɖi siwo katã le abe chalky ene la ɖe dzi. 2. Ŋku ƒe Tame ƒe Trɔtrɔ Ðeka (Le Nukpɔkpɔa Me alo ER): - Bia tso dɔnɔa si be akpɔ eƒe afɔkpawo tẽe le ƔEYIƔI ME eye wòayi edzi anɔ ŋku lém ɖe anyi (esia naa ŋkume ƒe akpa si le etame ƒe lãmeka si le dzi yim la ɖea dzi ɖi). - Lé ŋkumeɖonu siwo le etame la blewuu le wò asibidɛ gã kple asibidɛ si wotsɔ fiaa nu dome eye nàhe etame nutsyɔnu la ayi anyime vie eye nàdzo le ŋkumeʋuʋua gbɔ. - Da kotoklobo ƒe asike ɖe ŋkume ƒe akpa si le etame ƒe titina (le tarsal cartilage plate sesẽa ƒe etame, si didi abe sentimeta 1 ene le ŋkume ƒe fli la tame) la dzi wòanye afɔti. - Klo ŋkume ƒe akpa si le etame la ɖe dzi le kotoklobo la dzi ale be ememe pink (tarsal conjunctiva) natrɔ ɖe eme ayi gota, tsɔ wò asibidɛ lée ɖe ŋgonu ƒe ƒu ŋu, eye nàtsɔ kotoku si me tsi le evelia atutu ememe nutsyɔnu si ɖe go la ŋu esime nèle tsi dem. 3. Tɔtrɔ zi eve le Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ (Desmarres Lid Retractor Zazã): - Esi wònye be fornix si le etame ƒe akpa si goglo wu bɔbɔ nɔ ta tarsal plate si woxatsa la ta la, eversion ɖeka si me wotsɔa kotoklobo ƒoa nui la gakpɔtɔ ɣlaa kotoku si goglo wu. - Le Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ la, ne atikewɔla la de proparacaine-tsi siwo wotsɔna ƒoa tsii ɖe lãme vɔ la, ezãa ga si le abe sɔti ene Desmarres Eyelid Retractor tsɔ trɔa etame nutsyɔnu la second (double eversion), si wɔnɛ be deep superior cul-de-sac bliboa katã dzena, eye wòzãa forceps + wet swabs (kple 1% va ɖo 2% Disodium EDTA chelation drops na calcium hydroxide lime plaques sesẽ siwo wotsɔ de eme) be woaɖe kristalo ɖesiaɖe si wokpɔna le nusuekpɔmɔ̃ me ɖa.

4. Tsidede Kɔdzi Madzudzɔmadzudzɔe kple Morgan Lens kple Litmus pH Dodokpɔ¶

Ne dɔnɔa nya ɖo dɔnɔdzikpɔʋu alo Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ ko la: 1. Break Blepharospasm with Topical Anesthetic: Atikewɔla la dea 0.5% proparacaine alo tetracaine ƒe tsitete 2 ŋku si ŋu dɔlélea le la me. (De dzesii: Wozãa atike siwo wotsɔna fa alɔ̃e si wotsɔna ƒoa alɔ̃e vevie hena dɔlélewo didi ƒe dodokpɔ kpata kple tsidede agble ƒe ɖoɖowo le kɔdzi; mègaŋlɔ ŋkumeɖonu si nana ame ƒe lãme gbãna ƒe aŋetu alo tsɔe yi aƒeme gbeɖe o, elabena proparacaine/tetracaine zazã enuenu le aƒeme nana ŋkume ƒe ŋkume ƒe ʋuʋu ƒuna). 2. De Morgan Lens eme (ne ègbe Open Globe Rupture kple sweeping solid chunks vɔ megbe): Morgan Lens nye polymethylmethacrylate scleral shell si wotsɔ aŋe wɔe si wotsɔ bla ɖe IV tubing ŋu si tsia tsi si sina toa ŋkume ƒe ʋuƒo dzi, si léa ŋkume ƒe ŋkumeʋuʋu ɖe te eye wòklɔa ŋkume ƒe ŋkume bliboa eye wòklɔa ŋkume ɖaa ɣesiaɣi le ** 1 va ɖo 2 lita ƒe Lactated Ringer's le gaƒoƒo ɖeka me** evɔ mahiã be dɔnɔdzikpɔla natsɔ asi alé ŋkumeʋuʋuawo ɖe vovo o. 3. Aɖabaƒoƒo 30 ƒe Sea kple Aɖabaƒoƒo 5 ƒe Lala Hafi Woado pH Dodokpɔ: - De tsi atraɖii hena aɖabaƒoƒo 30 ya teti (zã tsi lita 1 va ɖo 3 ya teti). - Tsi tsidedee ƒe tsi eye LALƆ Aɖabaƒoƒo 5 va ɖo 10 hafi nàka asi pH litmus pepa ŋu ɖe ŋkume ƒe fornix si le ete la ŋu. (Nukatae nàlala miniti 5 va ɖo 10? Ne èka asi litmus-pepa ŋu ɖe ŋkua ŋu le sɛkɛnd 2 megbe le saline kotokua tsitsi vɔ megbe la, ɖeko nèle Lactated Ringer ƒe tsi si bɔbɔ nɔ ŋkua dzi ƒe pH dzidzem, ke menye atike si le dodom tso ŋkume ƒe stroma me ake o). - Target Normal Tear pH: \(\text{pH } 7.0\text{ va ɖo }7.4\) (eye wòsɔ kple hati ŋku si mexɔ abi o). - Ne pH gakpɔtɔ nye \(>7.4\) alo \(<7.0\) la, gbugbɔ dze tsidedee gɔme enumake kple tsi lita 1 va ɖo 2 bubu eye nàgbugbɔ ŋkume ƒe akpa si le etame la atrɔ be nàdi lime alo siminti sesẽ aɖe si bu si ɣla ɖe fornix gogloa me. - Ne pH nya ɖo \(7.0\text{ va ɖo }7.4\) ko la, gagbugbɔ lé ŋku ɖe pH la ŋu le miniti 30 megbe be nàkpɔe ɖa be alkali goglo siwo wodzra ɖo ɖe ŋkume ƒe ŋkume alo ŋgɔgbexɔa me megaɖe do goe be wòagadzi anyigba ƒe pH ɖe dzi ake o.

Dɔdaƒe ƒe sesẽme ƒe dzeside: Roper-Hall kple Dua ƒe hatsotsowo (Nusitae "Yevu" Fia Ŋkuagbã)¶

Ne ŋkua ɖo pH si mewɔa akpa aɖeke o si li ke si nye \(7.0\text{ va ɖo }7.4\) vɔ la, ŋkudɔdala la tsɔa fluorescein amadede si ƒe amadede nye amadede dzẽ-amadede dzẽ ƒoa ɖi ŋkua ƒe ŋkume le akaɖi si ƒe amadede nye cobalt-blɔ te eye wòléa ŋku ɖe nu eve ŋu: ŋku ƒe ŋkume ƒe kɔ nyuie kple gaƒoɖokui gaƒoƒo siwo me ŋkume ƒe ŋkumeʋuʋu ɣi si me ʋu mele o le ƒo xlã ŋkua ƒe go kemɛ (limbal ʋu ƒe sisi le lãme na ame).

Egbegbe kɔdzi ƒe atikewɔwɔ be woatsɔ axe mɔ ɖe ŋkume ƒe ʋuʋu nu le dzobibi vevie megbe¶

Le Dzeside II, III, kple IV ƒe atikewo ƒe dzobibi me la, ne wowu tsidede wo nu vɔ la, ŋkudɔdalawo dzea atike geɖe zazã ƒe ɖoɖo si woɖo taɖodzinu na gɔme be ŋkume ƒe ŋkume nagaɖu nu o (sterile corneal ulceration / keratolysis si matrix metalloproteinase [MMP] collagenase enzymes hena vɛ): 1. Ascorbic Acid (Vitamin C, Oral \(2\text{ grams}\) zi ene gbesiagbe + Topical 10% Sodium Ascorbate ɖiɖina gaƒoƒo 1 va ɖo 2 ɖesiaɖe): Alkali ƒe dzobibi fiãa ciliary ŋutilã, si naa vitamin C ƒe agbɔsɔsɔ le tsi ƒe nukokoedoname me dzi ɖena kpɔtɔna alafa memama 80 (localized corneal scurvy). Vitamin C manɔmee la, ŋkume ƒe lãkusiwo mate ŋu awɔ hydroxylate proline kple lysine be woawɔ collagen ɖɔɖɔɖo ka yeyewo o. Vitamin C si wodona ɖe lãme kple esi wozãna le nu me ƒe agbɔsɔsɔ gã gbugbɔgaɖoanyi xea mɔ na ŋkume ƒe ʋuʋu si me dɔlékui mele o. 2. Sodium Citrate ƒe 10% ƒe ɖiɖi le teƒe ɖeka (Gaƒoƒo 1 va ɖo 2 ɖesiaɖe): Citrate naa calcium ions siwo le lãmenugbagbeviwo godo si polymorphonuclear neutrophils (PMNs hiã), si nana neutrophil ƒe gege ɖe lãme na ame ƒe lãme gblẽna eye wòxea mɔ na wo be womegaɖea collagenase enzyme siwo gblẽa nu la ɖa ɖe stroma si wotɔ dzoe la me o. 3. Doxycycline si woano (\(100\text{ mg}\) zi eve gbesiagbe) + Tetracycline Ami si wotsɔna ƒoa ƒui: Le eƒe dɔlékuiwutike ƒe dɔwɔwɔ godo la, doxycycline nye atike si xea mɔ na Matrix Metalloproteinase-9 (MMP-9 / corneal collagenase) ƒe mɔxenu sesẽ aɖe, si xea mɔ na ŋkume ƒe ŋkume si wotɔ dzoe la be wòagaƒo le Kwasiɖa 2 kple 3 me o. 4. Early Topical Topical Corticosteroids (Gbã Ŋkeke 7 va ɖo 10 KO, e.g., Prednisolone Acetate 1%): Wozãnɛ vevie le ŋkeke 7 gbãtɔwo me tsɔ tea ʋumenugbagbevi dzĩwo ƒe tsɔtsrɔ̃ sesẽ ɖe to, emegbe eɖiɖi kabakaba alo wodzudzɔ le Ŋkeke 7 va ɖo 10 megbe elabena steroid siwo wonana le Ŋkeke 10 megbe xea mɔ na fibroblast collagen ƒe wɔwɔme eye na ŋkume ƒe ʋuʋu kabakaba (negbe ɖe wotsɔe kpe ɖe progestational steroids abe medroxyprogesterone ene ŋu ko hafi). 5. Cycloplegic Drops (Atropine 1% alo Cyclopentolate 1%; NEVER Phenylephrine): Eɖea vevesese si nye ciliary muscle spasm dzi kpɔtɔna eye wòxea mɔ na iris si xɔ dzo la be wòagalé ŋku ɖe ŋkume ƒe ŋkume ŋu o (posterior synechiae). Wotsi tre ɖe phenylephrine ŋu vevie elabena enye alpha-1 vasoconstrictor si nana limbal ischemia gagblẽna ɖe edzi. 6. Early Cryopreserved Amniotic Membrane Transplantation (AMT / Prokera): Wotsɔe da ɖe aba to le gaƒoƒo 24 va ɖo 72 me be wòado lãkusi ƒe dɔyɔyɔ ɖe ŋgɔ eye wòaɖe limbal stem cells siwo tsi agbe.

Nɔnɔme tɔxɛ aɖe: Superglue (Cyanoacrylate) si ge ɖe ŋkua me le vo me¶

Esi wònye be cyanoacrylate superglue (alo asibidɛ ƒe aŋe) ƒe aŋetu sue siwo wotsɔa aɖatsi ƒoa nui ƒe aŋetuwo ƒe dzedzeme sɔ kple ŋkudɔ si woŋlɔ na ame alo ŋkumeɖonu si wotsɔa aɖatsiwo wɔe kloe ta la, ne wodoe ɖe ŋkua me le vo me nye nusi bɔ ɖe aƒeme kpata: - Nya Nyui: Cyanoacrylate glue wɔa polymerize enumake ne eƒo tsia le aɖatsi me eye wòblana ɖe protein ƒe anyigba ƒuƒuwo ŋu wu (ŋku ƒe ɖa kple ŋkume ƒe axawo), ƒã hafi wòblana ɖe ŋkume ƒe lãkusi gbagbe si xɔ dzo, si ŋu mucin le la ŋu tegbee. me gena ɖe ŋkua me abe lye ene o. - Nusi Nàwɔ Enumake: 1. De tsi enumake kple pɔmpi me tsi dzodzoe alo dze hena miniti 15 be nàkɔ tsi monomer si mesesẽ o la ɖa eye wòana dzobibi nafa. 2. MÈGAhe ŋkumeɖonu siwo wotsɔ aŋe blae la ɖa le wo nɔewo ŋu sesẽe GBEÐE o, eye MÈGANA ame aɖeke nazã acetone, ɖaɖenu, alo atike siwo te ɖe ŋkua ŋu GBEÐE o. Acetone nana ŋkume ƒe ŋkume biãna vevie, eye ne èvuvu ŋkume ƒe ɖa siwo wotsɔ glue bla ɖe wo nɔewo ŋu la, eɖea ŋkume ƒe ŋutigbalẽ ɖa eye wòvuvua ŋkume ƒe ŋkume. 3. Le Kpata Dɔwɔƒe: Ne wotsɔ aŋe bla ŋkumeʋuʋu keŋkeŋ (chemical tarsorrhaphy) eye aŋe sesẽ si me mekɔ o ƒe akpa aɖeke mele ŋkume ƒe ŋkumeʋuʋua ƒom le ete o la, ŋkudɔlékuiwutike si me dɔmenyonyo le (erythromycin alo bacitracin petrolatum ami) sisi ɖe eŋu zi 4 gbesiagbe ana kadodo si le aŋea kple ŋutigbalẽ kukua dome la me lãmenugbagbeviwo/aɖabɛwo, si wɔnɛ be ŋkumeɖonuawo ʋuna le wo ɖokui si afɔku aɖeke manɔmee le ŋkeke 1 va ɖo 4 me (alo ŋkudɔdala ate ŋu atso ŋkumeɖonu ɖekaɖeka siwo wotsɔ aŋe blae la nyuie le nusuekpɔmɔ̃ me).

Nutome ƒe xexlẽdzesi siwo ku ɖe nudzɔdzɔ kpatawo ŋu kple dɔwɔƒea ƒe ɖoɖowo¶

• United States kple Canada: Dze tsilele gɔme enumake eye nàna ame aɖe naƒo ka na 911 kple US Poison Control (1-800-222-1222). OSHA (29 CFR 1910.151[c]) kple ANSI/ISEA Z358.1 ye kpɔa ŋkumekɔklɔdɔwɔƒewo dzi, siwo de se be woatsɔ asi klɔ ŋkumekpɔƒe si me pɔmpi le le sɛkɛnd 10 (afɔ 55 / meta 16.8) me tso esime afɔku ɖesiaɖe si gblẽa nu le ame ŋu si tsɔa tsi fafɛ (\(16 degrees\text{C to }38 degree C\) / \(60 degrees\text{F vaseɖe }100 degree F\)) le \(1.5\text{ lita le miniti ɖeka me}\) hena miniti 15 ya teti.
• United Kingdom: Klɔe enumake eye nàƒo ka na 999 (alo 112). Le NHS, Fiaɖuƒea ƒe Ŋkudɔdalawo ƒe Kɔledzi (RCOphth), kple TOXBASE (Dukɔa ƒe Aɖi Ŋuti Nyatakaka Dɔwɔƒe) ƒe mɔfiamewo nu la, dɔnɔdzikpɔʋuwo ƒe dɔwɔlawo dzea tsidede tsi si me wodea dze enumake gɔme enumake le mɔzɔzɔ yi Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ si me ŋkudɔléle ƒe nutsyɔtsyɔ 24/7 le.
• European Union: Klɔ enumake eye nàƒo ka na 112. Dɔwɔƒewo ƒe dedienɔnɔ ŋuti mɔfiamewo (EU-OSHA) bia be woaɖe ɖiƒoƒo ɖa le teƒea enumake hafi atsɔ dɔnɔdzikpɔʋuwo ayi teƒea.
• Australia kple New Zealand: Klɔ enumake eye nàƒo ka na 000 le Australia (Aɖiwo Ŋuti Nyatakaka Dɔwɔƒe 13 11 26) alo 111 le New Zealand (0800 764 766). Wɔ ɖe RANZCO kple ANZCOR Mɔfiame 9.2.3 / 9.1.4 dzi hena ŋku ƒe atike ƒe abixɔxɔ.
• India kple Asia-Pacific: Klɔ enumake eye nàƒo ka na 112 le India, 119 le Japan kple South Korea, alo 995 le Singapore. Le nuto siwo me wodzraa calcium hydroxide (chuna / edible slaked lime paste si wozãna kple betel quid/paan) ƒe bablawo ɖo le aƒewo me la, xlɔ̃ nu ƒomewo be plastic chuna babla siwo gba ɖe ɖevi ƒe ŋku me hea Grade IV lime dzobibi si gblẽa nu ŋutɔ vɛ si hiã be woawɔ upper fornix double-eversion kple EDTA scrubbing enumake.

Kpɔ ɖa xexlẽdzesi siwo wozãna kpata na dukɔwo dome dɔdɔ kpata ƒe xexlẽdzesiwo katã.

Nya siwo wobiaa amewo enuenu¶

Ne dzetsi si me dɔlékui mele o mele asinye le aƒeme ne tsiɖɔɖɔɖɔɖɔɖomɔ̃ ƒo ɖe nye ŋkume o la, ɖe pɔmpi me tsi agblẽ nu le nye ŋkume ƒe ŋkume ŋua?¶

Ao; pɔmpi me tsi dzadzɛ dzro si tso wò nuɖaƒe ƒe tsinyegoe, tsileƒe, alo abɔ me tsiléƒe le dedie keŋkeŋ eye wòɖea ame ƒe agbe na ŋkudede tsi kpata. Dɔdamɔnu ŋuti numekukuwo ɖo kpe edzi be ne wodze pɔmpi me tsi sisi gɔme le sɛkɛnd 5 me tso esime atike aɖe ƒo ɖe eme la, ekpɔa ŋku nyuie wu be woalala aɖabaƒoƒo 2 gɔ̃ hã hafi adi dze si me dɔlékui mele o; atike si gblẽa nu le ame ŋu la kɔklɔ le sɛkɛnd 30 gbãtɔwo me nye nu ɖeka kolia si ɖea ŋkua tso tsi si gbã ŋku me.

Nukatae siminti, aŋɔ, alo lime ƒuƒu si le ŋkua me vɔ̃ɖi wu acid si nye tsi?¶

**calcium hydroxide**, si nye alkali sesẽ aɖe si ƒe pH le 12.0 kple 12.9 dome la le siminti si xɔ dzo, kɔkrit, aŋɔ, aŋɔ, kple lime si wotsɔ ƒo ƒui me. To vovo na aɖi si nye tsi la, lime kple siminti si xɔ dzo la wɔa ƒuƒoƒo siwo léna ɖe nu ŋu, siwo me ʋuʋudedi le, siwo ɣlana ɖe ŋkume ƒe akpa si le etame kple ete te goglo le ŋkume ƒe ʋuʋudedi me, eye wowɔa dɔ abe atikewo ƒe tsidzraɖoƒe si nɔa ŋkua ʋuʋum gaƒoƒo 24 va ɖo 48 negbe ɖe ɖɔkta trɔ ŋkume ƒe akpa si le etame zi eve eye wòtutua ŋkume ƒe akpa ɖesiaɖe hetsɔa chelate ɖa.

Nukatae ʋu ƒe yaƒoƒo ƒe agba si wozãna ate ŋu ana atike nafiã ŋku vevie ne naneke meƒo nye mo o gɔ̃ hã?¶

Ʋu ƒe yakotoku siwo wozãna tsã la ya dzona to **sodium azide ($\text{NaN}_3$)** ƒe dzobibi kabakaba me, si wɔnɛ be nitrogen gas dona kpe ɖe aerosol-tu ɣi nyui aɖe si me **sodium hydroxide ($\text{NaOH}$, lye) kple alkaline metallic oxides** le si woɖena to ʋuʋudedi siwo le yakotokua ƒe avɔ me me. Ne alkaline powder ma dze aɖatsi ƒe tsi dzi la, ewɔa **alkali chemical keratitis** si me pH sɔ gbɔ ɖo si hiã be woado pH kpɔ enumake eye woade tsi wo kple dze geɖe.

Nukatae mele be mazã vinegar si gbɔdzɔ atsɔ aɖe lye ƒe dzobibi ɖa alo baking soda tsi atsɔ aɖe batri ƒe acid ƒe dzobibi le ŋkua me ɖa o?¶

Acid kple base tsakatsaka tẽ ɖe ŋkume ƒe ŋkumeʋuʋu dzi hea **exothermic (heat-producing) neutralization reaction** si ɖea dzoxɔxɔ ƒe ŋusẽ ɖe ŋku si gblẽ la dzi, si ɖaa ŋkume ƒe collagen eye wònaa lãmenugbagbeviwo ƒe tsɔtsrɔ̃ zi gbɔ zi eve. Tsi gbadza alo Lactated Ringer’s naa atike siwo le eme la tsia dzodzodzoe eye wòtsɔa wo dzonae esime wòle ŋkua fa miamiamia le ɣeyiɣi ɖeka me.

Nukatae ɖɔkta si kpɔa dɔnɔdzikpɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ gbe be yematsɔ ŋkumeɖonu siwo nana nye ŋku ƒe vevesese nu tsina la ayi aƒemee o?¶

Wozãa ŋkumeɖonu siwo wotsɔna fa alɔ̃e (abe proparacaine alo tetracaine ene) ɣeyiɣi kpui aɖe le xɔ si me wowɔa dɔ kpata le ale be ɖɔkta nate ŋu atɔ te ŋkume ƒe ʋuʋu eye wòaklɔ ŋkua. Gake ne wozã atike siwo wua ŋkume enuenu le aƒeme la, aɖi nyea aɖi na ŋkume ƒe lãmenugbagbeviwo, xea mɔ na abi ƒe dɔyɔyɔ, ewua ŋkume ƒe lãmekawo, eye wònana ŋkume ƒe ŋkume ʋuʋuna heɖea do (**anesthetic abuse keratopathy**); aƒeme vevesesenutsitike siwo le dedie zãa vevesesenutsitike siwo woano, ami si wotsɔa amisisi, kple cycloplegic drops.

Nukatae ŋku si fiã vevie la dzena ɣie keŋkeŋ ɣeaɖewoɣi le esi teƒe be wòanɔ dzo dam abe ʋu ene?¶

Ne nusi doa dziku na ame fafɛ aɖe dze ŋkua dzi la, ʋuka siwo le lãmesẽ me le ŋkua dzi la kekena eye wozua dzĩe. Ne alkali si me wode nu me abe lye, ammonia, alo lime ene va dze ŋkua dzi la, etsɔa atikewo fiãa ʋuka siwo katã ƒo xlã ŋkume ƒe ŋkumeʋuʋu eye wògblẽa wo dome (**limbal ischemia**), si wɔnɛ be ŋkua trɔna zua ɣie si nye porcelain marble kuku; asigɛ ɣi si me ʋu mele o si ƒo xlã ŋkume ƒe ŋkume ƒe ŋkume le atikewo ƒe sisi vɔ megbe ɖee fia be Dzobibi sesẽ aɖe le Dzeside IV me si hiã be woawɔ dɔ na ŋkudɔ enumake.

Mɔfiame siwo do ƒome kplii¶

• Siminti, kɔnkrit xɔdzo, alkali ƒe atike siwo wotɔ dzoe, kple lime ƒe ŋkumekpɔkpɔ
• Hydrofluoric acid, nusi ɖea gbeɖuɖɔ ɖa, kple atikewo ƒe dzobibi ɖeɖeɖa
• Chili pepper kple capsaicin biãna le ŋkuwo, ŋutigbalẽ, kple asiwo me
• Ŋku ƒe abixɔxɔ kple beléle kpata

Dzɔtsoƒewo kple dziɖuɖumegãwo ƒe mɔfiame¶

• American Academy of Ophthalmology (AAO, United States): Nuwɔna ƒe Kpɔɖeŋu si Wodi Kple Dɔdaƒe Ŋuti Nyatakakawo le Ŋku ƒe Atikewo ƒe Dzobibi Dzi Kpɔkpɔ Kpata Ŋu (Alkali kple Acid Keratopathy, Fornix Sweeping, kple Roper-Hall/Dua Grading).
• Fiaɖuƒea ƒe Ŋkudɔdalawo ƒe Kɔledzi (RCOphth, United Kingdom): Dɔwɔƒe ƒe Dɔwɔnawo Dzikpɔkpɔ ƒe Mɔfiamewo: Atikewo ƒe Nuveviwɔame na Ŋku kple Tsidede Tsidede Kpata ƒe Ðoɖowo.
• Dɔwɔƒe ƒe Dedienɔnɔ kple Lãmesẽnyawo Gbɔkpɔha (OSHA, United States) kple ANSI/ISEA Z358.1: Dzidzenu na Ŋkuklɔ kple Tsilele Dɔwɔnuwo Kpata.
• Amerika Dzi Habɔbɔ (AHA) kple Amerika Atitsoga Dzĩ Habɔbɔ: Mɔfiamewo na Kpekpeɖeŋu Gbãtɔ: Tsidede Tsi le Pɔmpi me Enumake na Atikewo ƒe Abixɔxɔ le Ŋku me.
• Australia kple New Zealand Kɔmiti si Kpɔa Gbɔgbɔyɔyɔ Gbɔ (ANZCOR) kple RANZCO: Mɔfiame 9.2.3: Kpekpeɖeŋunana Gbãtɔ le Ŋku ƒe Abixɔxɔ kple Atikewo ƒe Dɔwɔnawo Dzi Kpɔkpɔ.