Chemical Agents of Opportunity for Terrorism: TICs & TIMs

Chemical Agents of Opportunity for Terrorism
Training Support Package
Participant Guide
Chemical Agents of Opportunity for Terrorism:
TICs & TIMs
Anhydrous Ammonia
• Concentration and duration of exposure determines clinical
effect
– From minor irritation to blindness with extensive scar formation
• Center picture shows fluorescein uptake indicating diffuse
corneal injury
Module One – Toxic Industrial Gases as Terrorist Threats
24
This slide demonstrated what happens when anhydrous ammonia comes in contact with
the eye. The cornea which covers the eye is very sensitive to minor irritation. A
corrosive exposure (higher concentration and/or more prolonged contact) may cause a
chemical burn to the cornea and result in irreversible scarring. These photos illustrate
what may occur after such a corneal injury. The intense fluorescein staining (a greenish
dye under UV light) shown in the middle at the time of injury led in this case to
irreversible scarring and blindness.
The photo on the left demonstrates inflammation of the conjunctiva and cornea – the
epithelial layer covering the eye (conjunctival “injection” or vascular congestion, and
corneal clouding – appears as opaqueness – secondary to corneal edema). The middle
photo shows what occurs when the green fluorescein dye is applied to the cornea and
viewed with an ultraviolet light. With a normal cornea there should be no uptake with the
fluorescein. The uptake of fluorescein in this middle photo suggests widespread injury to
the cornea.
The photo on the right shows the long term results of a chemical burn to the eye and
subsequent scar formation. In the scarred eye, blood vessels grow into the tissue. The
scarring results in a permanent opacity in what is suppose to be a translucent cornea.
Such an opacity results in blindness.
December 2008 Version 2.0 Page 148