Clinical Report: Pannus may recur after sodium amide eye injury

Overview

A case report describes the 36-month course of a 23-year-old man with severe bilateral ocular injury after exposure to sodium amide. Epithelial healing was prolonged, fibrovascular pannus recurred or progressed despite repeated resections and medical treatment, and visual outcomes differed substantially between eyes.

Background

Chemical ocular burns can damage the corneal epithelium and limbus, with subsequent risks including delayed epithelial healing, tissue thinning, symblepharon, and fibrovascular pannus. The report describes sodium amide as a caustic hazard to the eyes and skin, while the authors found no prior specific ocular cases in their English-language literature search. The case is clinically notable for its prolonged follow-up and recurrent pannus after a severe bilateral exposure. Its single-patient design and use of multiple concurrent treatments limit conclusions about typical outcomes or the effect of individual interventions.

Data Highlights

Key Findings

• The injury followed an industrial explosion involving a glass container of sodium amide; the patient irrigated with tap water for 15 minutes before emergency-department irrigation with 7 L of sterile water and normal saline.
• At the first outpatient examination on day 6, both eyes had extensive limbal ischemia, epithelial defects, and dense corneal opacification; amniotic membranes were placed over both corneas.
• Epithelial recovery was prolonged in both eyes but faster in the left: complete healing was documented by 2 months, whereas right-eye healing was estimated to have taken 90–143 days.
• Fibrovascular pannus began invading both corneas at 2.75 months and continued despite anti-inflammatory treatment. It recurred after initial left-eye resection and later progressed in other corneal quadrants.
• At 36 months, the left eye had substantially better vision, with refraction yielding 20/25; right-eye uncorrected acuity remained 20/100 to 20/300 during months 30–36.
• The authors reported no specific prior sodium amide ocular-injury cases in their English-language search, while noting that English-only search terms could have missed relevant reports. They also cautioned that one case and multiple treatments precluded determining general prognosis or the contribution of individual therapies.

Clinical Implications

This case documents that prolonged epithelial healing, recurrent pannus, tissue thinning, and symblepharon can occur during follow-up after severe bilateral sodium amide injury. The authors’ report does not establish the frequency of these outcomes or the effectiveness of any individual treatment, because it describes one patient who received multiple interventions.

Conclusion

In this single case, severe sodium amide ocular injury was followed by prolonged epithelial healing and persistent or recurrent fibrovascular pannus over 36 months. Visual recovery differed markedly between the eyes, and the report cannot establish whether this course is representative of other patients.

Related Resources & Content

1. Case report, source article -- Pannus may recur after sodium amide eye injury
2. College of Optometrists, Clinical Management Guidelines -- Trauma (chemical)
3. American Academy of Ophthalmology, PubMed -- Efficacy of Amniotic Membrane Grafting for the Treatment of Chemical and Thermal Ocular Surface Injuries: A Report by the American Academy of Ophthalmology
4. Ophthalmology Management, 2020 -- Clinical Utility of Amniotic Membranes
5. Optometric Management — TREATMENT WITH AMNIOTIC MEMBRANES
6. Ophthalmology Management — Neurotrophic Keratopathy: New Treatment Strategies
7. optometric management — TREATMENT WITH AMNIOTIC MEMBRANES
8. Trauma (chemical) - College of Optometrists
9. Efficacy of Amniotic Membrane Grafting for the Treatment of Chemical and Thermal Ocular Surface Injuries: A Report by the American Academy of Ophthalmology
10. Clinical Utility of Amniotic Membranes
11. Corneal Neovascularization - EyeWiki