Dua Classification of Chemical Ocular Injuries
Modern 6-grade classification (Dua 2001) using analogue clock-hour limbal involvement and percentage conjunctival involvement. More granular than Roper-Hall, with better prognostic accuracy.
Score interpretation
→ Copious irrigation until pH neutral. Topical antibiotic + preservative-free tears. Outpatient review 24–48 h.
→ Same-day ophthalmology. Add topical steroid once epithelium stable, oral vitamin C, doxycycline, citrate drops. Consider amniotic membrane transplant if non-healing at day 7.
→ Urgent admission and specialist cornea care. Anticipate limbal stem-cell deficiency. Early amniotic membrane patch and aggressive lubrication. Glaucoma surveillance.
→ Tertiary cornea centre — keratoprosthesis pathway or limbal allograft after globe stabilisation. Counsel on guarded visual prognosis.
Interpretation bands for the Dua. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Tranexamic Acid (ICU/Trauma/Surgical) · Antifibrinolytic
- Retinol palmitate with white soft paraffin, light liquid paraffin, liquid paraffin and wool fat · Ocular lubricant ointment
- Yellow soft paraffin · Emollient / Ocular lubricant
- Silver Nitrate · Chemical Cautery — Epistaxis
- Dexamethasone 0.1% Eye Drops (Maxidex) · Topical corticosteroid (ocular anti-inflammatory)
- Proxymetacaine 0.5% Eye Drops (Minims Proxymetacaine) · Topical ocular anaesthetic
- Acute Red Eye / Vision Loss Screen · RCOphth 2020; NICE CKS
- Idiopathic Intracranial Hypertension · ABN; consensus 2018
- Acute Red Eye Assessment · RCOphth / AAO
- Acute Angle Closure Glaucoma · RCOphth / EGS Guidelines
- Retinal Detachment · RCOphth Guidelines / EURETINA
- Diabetic Retinopathy — Screening and Management · NICE NG28 2016 / NHS DES Programme
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.