Objective. Report on a serious grade IV eye burn (classification following Ropper-Hall) which healed under topical treatment.

Case report. A 49 year old woman was the victim of an aggression due to projection of chemical products into her eyes. Clinically the right eye presented a conjunctival and limbal ischemia 360°, with scleral necrosis on the infero-nasal region and a total denuded corneal stroma. A first ocular rinsing was performed 1 hour after the accident with 1 liter of Diphoterine. This rinsing was followed by instillation of dexamethasone every 20 minutes for 2 hours and 6 times a day. Additional ascorbate was given on the one hand topically (6 times a day) and on the other hand orally (3g a day). Artificial tears were added later.

Results. This treatment resulted in a progressive corneal scarring followed by a pseudo-pterygium in the infero-nasal region being stable with a visual acuity of 14/20.

Conclusions. A conservative treatment protocol, correctly conducted, might in special cases heal even severe eye burns. It was especially astonishing on the background of a extreme delay in eye rinsing. The clinical emergency treatment which is mostly recommended has to be direct rinsing. We believe to have been able to obtain a good result in this case, despite the belated treatment of the burn (60 minutes) thanks to the use of Diphoterine.