From the Guidelines
Chemical eye damage requires immediate irrigation with a copious amount of tap water for at least 15 minutes to minimize damage and prevent long-term vision loss. The most recent and highest quality study, published in 2024 by the American Heart Association and American Red Cross, recommends decontamination by irrigation immediately after chemical exposure to the eyes 1. This study suggests that irrigation with tap water is the preferred method, unless otherwise recommended by local guidelines.
When providing first aid for chemical eye injury, it is essential to avoid contaminating other individuals, areas, or the other eye with the caustic substance 1. If tap water is not available, irrigation with normal saline, Ringer’s lactate solution, or a commercial eye wash solution is a reasonable alternative 1.
Key considerations in managing chemical eye damage include:
- Immediate irrigation with tap water for at least 15 minutes
- Avoiding contamination of other individuals or areas
- Seeking emergency medical attention immediately after irrigation
- Potential administration of topical anesthetics, antibiotic drops, and steroid drops by medical professionals
- Follow-up with an ophthalmologist to monitor for complications such as glaucoma, cataracts, or corneal scarring
The severity of damage depends on the chemical type, with alkali burns generally being more serious than acid burns 1. Alkali burns can penetrate deeper and cause progressive damage, leading to permanent vision loss if not treated promptly.
In real-life clinical practice, it is crucial to prioritize caution and take immediate action when dealing with chemical eye damage. The evidence from the 2024 American Heart Association and American Red Cross guidelines 1 supports the importance of prompt irrigation and medical attention to minimize morbidity, mortality, and improve quality of life outcomes.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Chemical Eye Damage Overview
- Chemical eye damage is a medical emergency that requires immediate intervention and structured ophthalmic assessment without unnecessary delay 2
- Chemicals, particularly alkali, can cause profound damage to the anatomy of the ocular surface or even deeper eye structures, leading to potentially sight-threatening injuries 2, 3
Causes and Types of Chemical Eye Damage
- Alkali injuries occur more frequently than acid injuries and can result in more serious damage 3, 4
- Acid injuries can also cause significant damage, but are less common than alkali injuries 3
- The extent of ocular surface damage is influenced by the type, temperature, volume, and pH of the corrosive substance and duration of exposure 5
Emergency Management and Treatment
- Immediate assessment and initiation of treatment are crucial in determining visual outcome 3
- Eye irrigation must be instituted immediately at the scene of exposure and continued in the emergency department to reduce visual impairment 5
- Traditionally, lactated Ringer's and normal saline have been used as irrigation fluids, although other irrigation fluids may also be effective 5
- Reconstructive surgery may be necessary in some cases, and can give very good results in carefully selected cases 2
Prevention and Awareness
- Promoting awareness of proper immediate action in cases of chemical eye injury is essential to improve knowledge among the general public 6
- A study found that 78.5% of respondents indicated washing with water as the first step in case of chemical eye injury, while 18.5% indicated visiting the emergency department 6
- However, 8.4% of respondents believed that an eye injured with an acidic material should be washed with an alkaline solution, highlighting the need for education and awareness 6