Late-onset limbal ischemia in alkali burns

Chemical injury is one of the common ocular emergencies in ophthalmology practice. Ocular burns, especially with alkaline solution, can lead to hazardous effects on eye structures. Limbal ischemia resulting from such injury carries a grave prognosis. Lack of standard criterion results in difficult assessment of limbal ischemia. Diagnosis of limbal ischemia is purely dependent on subjective assessment. A 40-year-old female presented to our emergency department with alkali injury. Alkali injury was promptly diagnosed and treated. There was no sign of limbal ischemia during initial evaluation. On follow-up, the patient developed late-onset limbal ischemia.