From the Guidelines
The treatment for chemical conjunctivitis primarily involves immediate irrigation of the affected eye with copious amounts of sterile saline or clean water for at least 15 minutes to dilute and remove the chemical irritant, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Key Recommendations
- Decontamination by irrigation should be performed immediately after chemical exposure to the eyes, with a copious amount of tap water for 15 minutes, unless otherwise recommended by local guidelines 1.
- Eye irrigation with normal saline, Ringer’s lactate solution, or a commercial eye wash solution is reasonable if immediately available 1.
- Patients with ocular exposure to industrial chemicals should adhere to local guidelines or recommendations from a poison center 1.
Treatment Approach
After irrigation, the following steps can be taken:
- Artificial tears or lubricating eye drops can be used to soothe the eye and promote healing.
- Oral analgesics like acetaminophen or ibuprofen can be used for pain management.
- If inflammation is severe, a short course of topical steroids may be prescribed.
- Antibiotic drops may be added if there's a risk of secondary infection.
- Patients should avoid rubbing their eyes and should not wear contact lenses until symptoms resolve completely.
Referral to Ophthalmologist
Patients with chemical conjunctivitis should be evaluated by an ophthalmologist in cases of visual loss, moderate or severe pain, or severe, purulent discharge, as recommended by the conjunctivitis preferred practice pattern 1.
From the Research
Treatment Guideline for Chemical Conjunctivitis
There are no research papers to assist in answering this question as the provided studies focus on the diagnosis and treatment of conjunctivitis caused by viruses, bacteria, or allergies, but do not specifically address chemical conjunctivitis.
Available Information on Conjunctivitis Treatment
- The treatment for viral conjunctivitis is supportive, and may include artificial tears, cold compresses, and antihistamine eye drops 2.
- Topical antihistamines with mast cell-stabilizing activity are the treatment of choice for allergic conjunctivitis 2.
- Bacterial conjunctivitis is typically treated with topical antibiotics, although delayed antibiotic prescribing has been found to have similar symptom control as immediate prescribing 2.
- The majority of cases of bacterial conjunctivitis are self-limiting and no treatment is necessary in uncomplicated cases, however, conjunctivitis caused by gonorrhea or chlamydia and conjunctivitis in contact lens wearers should be treated with antibiotics 3.
Factors Associated with Treatment
- A comprehensive history and physical examination can guide diagnosis and treatment of conjunctivitis 2.
- Concurrent diagnosis with acute otitis media and later study year were associated with reduced odds of prescribing ophthalmic antibiotics for conjunctivitis 4.
- Patients evaluated via telephone had a greater odds of being prescribed ophthalmic antibiotics 4.