What is the treatment for body fluid exposure in the eye?

Treatment for Body Fluid Exposure in the Eye

For body fluid exposure in the eye, immediate irrigation with clean water, saline, or sterile irrigants for at least 15 minutes is the essential first treatment step. 1

Immediate Management

Step 1: Irrigation

• Immediately irrigate the affected eye with clean water, saline, or sterile irrigants 1, 2
• Continue irrigation for at least 15 minutes 2, 3
• Keep eyelids open during irrigation to ensure thorough cleansing 2
• Direct water flow from the inner corner outward to prevent contamination of the unaffected eye 2

Step 2: Documentation and Reporting

• Report the incident to a supervisor 1
• Document the type of exposure including:
  • Type of body fluid involved
  • Source of the fluid
  • Extent of exposure 1

Post-Exposure Protocol

Medical Evaluation

• Seek immediate medical treatment after initial irrigation 1
• An ophthalmologist should examine the eye as part of the initial assessment 1
• Daily ophthalmological review is necessary during the acute phase 1

Risk Assessment

1. Identify the source patient if possible 1
2. Determine the likelihood that the source may have hepatitis B, hepatitis C, or HIV infection 1
3. Assess the exposed person's immunity status (particularly for hepatitis B) 1

Ongoing Eye Care

• Apply lubricant eye drops (e.g., nonpreserved hyaluronate or carmellose) every 2 hours 1
• Ocular hygiene should be performed daily by an ophthalmologist or ophthalmically trained nurse to remove inflammatory debris 1
• Consider broad-spectrum topical antibiotic prophylaxis if corneal damage is present 1

Bloodborne Pathogen Exposure Management

Hepatitis B Management

• For unvaccinated individuals exposed to HBsAg-positive source:
  • Administer hepatitis B immune globulin (HBIG) as soon as possible (preferably within 24 hours)
  • Begin hepatitis B vaccine series 1
• For vaccinated individuals with documented immunity (anti-HBs ≥10 mIU/mL):
  • No postexposure prophylaxis required 1

HIV Exposure

• Determine source patient's HIV status when possible
• Consider post-exposure prophylaxis based on exposure risk assessment
• Initiate prophylaxis as soon as possible if indicated 1

Common Pitfalls to Avoid

1. Delayed irrigation: Insufficient or delayed irrigation can significantly worsen outcomes 2
2. Rubbing the eye: A person with foreign body sensation should not rub their eye 1
3. Inadequate follow-up: Failure to seek medical evaluation after initial first aid 1
4. Incomplete documentation: Not documenting the exposure details properly 1
5. Overlooking bloodborne pathogen risks: Not considering hepatitis B, hepatitis C, and HIV transmission risks 1

Special Considerations

• For chemical exposures, the type of chemical may require specific decontamination protocols 2
• For unconscious patients, prevention of corneal exposure is essential using moisture chambers with polyethylene film 1
• Topical corticosteroid drops (e.g., nonpreserved dexamethasone 0.1%) may reduce ocular surface damage but should be used under ophthalmologist supervision 1

Body fluid exposures to the eye represent a significant occupational hazard for healthcare workers 4, 5, requiring prompt action to minimize both immediate tissue damage and potential infection transmission risk.