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Types
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Sulfur Mustard
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Lewisite
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Onset of ocular action
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No initial reaction; symptoms do not appear for some hours.
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Immediate and painful reaction.
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Pupillary reaction
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Not affected.
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Immediate strong miotic action.
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Vascularization
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Never occurs unless limbus is damaged.
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Independent of the site of the primary lesion; occurs when a sufficient dose reaches the cornea or limbus.
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Vascular lesions
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Do not all perforate; tend to be chronic, to relapse, and to show intracorneal hemorrhages from newly formed vessels; vessels have peculiar and characteristic form.
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Not all vascular lesions perforate; there are no relapses and no recurrent hemorrhages.
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Cholesterin and other lipoid scars
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Follow some vascular lesions, and subsequently these tend to break down (delayed mustard gas keratitis).
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Do not occur, and there is no late breakdown due to them.
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Perforation and loss of an eye
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Caused by relatively large doses (0.005 cc), and even then are long delayed. Perforation never occurs as a primary lesion before the stage of vascularization.
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Caused by relatively small doses (0.001 cc); perforation may occur within a few days without vascularization, or later after the entry of blood vessels.
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Edema
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Edema of the conjunctiva and cornea is present, but not excessive.
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Edema of the lids and conjunctiva is immediate and severe. Edema of the cornea is extreme in all but the smallest doses.
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Iris and ciliary body
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Relatively little involvement. No late effect on pigment.
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Early and severe involvement, followed by gradual depigmentation and shrinkage of the iris stroma.
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Vessel formation
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Characteristic vessels form in cornea and conjunctiva.
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Corneal vessels do not show the characteristic varicosities of mustard vessels.
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SOURCE: Adapted from Mann et al., 1946.
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