Roper-Hall Classification of Chemical Ocular Burns
Original classification of chemical (alkali/acid) eye injuries (Roper-Hall 1965), based on corneal involvement and limbal ischaemia. Predicts visual prognosis and guides referral urgency. The Dua classification (2001) is a more granular modern alternative.
Score interpretation
→ Copious irrigation (≥2 L Hartmann's/saline) until pH neutral and ≥30 min total. Topical antibiotic (chloramphenicol QDS), preservative-free lubricants, cycloplegic if photophobia. Outpatient ophthalmology review within 24 h.
→ Same-day ophthalmology assessment. As Grade I plus topical steroid (e.g. dexamethasone 0.1%) once epithelial defect not advancing, vitamin C oral 2 g/day, doxycycline 100 mg BD (collagenase inhibition). Citrate drops if available.
→ Urgent (<1 h) specialist ophthalmology. Admission. Intensive topical regime + amniotic membrane transplant if non-healing at day 7. Tear-film support, IOP monitoring, glaucoma management.
→ Emergency tertiary cornea referral. Limbal stem-cell deficiency expected. Tenoplasty / amniotic membrane patch acutely; planned penetrating keratoplasty + limbal allograft / keratoprosthesis once globe stabilised.
Interpretation bands for the Roper-Hall. 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.