What should be done in case of chemical exposure to the eye?

Management of Chemical Eye Exposure

In case of chemical exposure to the eye, immediate irrigation with copious amounts of clean water for at least 15 minutes is essential and should be started without delay to minimize preventable vision loss. 1, 2

Immediate First Aid Steps

1. Remove from exposure source

   • Immediately remove the person from the chemical exposure source
   • Remove contaminated clothing and jewelry to prevent trapping chemicals against the skin 1

2. Begin irrigation immediately

   • Use copious amounts of clean tap water (preferred due to immediate availability) 2, 1
   • Keep eyelids open during irrigation 1
   • Direct water flow from inner corner outward to prevent contamination of the unaffected eye 1
   • Continue irrigation for at least 15-30 minutes 2, 1

3. Alternative irrigation solutions (if immediately available)

   • Normal saline
   • Commercial eye wash solution
   • Lactated Ringer's solution 2, 1

Special Considerations

• For dry chemicals: Brush off as much powder as possible before irrigation to avoid spreading the contaminant and potential exothermic reactions with water 2, 1

• For specific chemicals: Hydrofluoric acid and phenol may require substances other than water for decontamination - consult poison control center (800-222-1222 in US) for specific instructions 2, 1

• Avoid common pitfalls:

  • Delaying irrigation
  • Failing to keep eyelids open during irrigation
  • Stopping irrigation too early
  • Using pressure or rubbing the eye
  • Applying eye patches before medical evaluation
  • Using topical anesthetics outside medical supervision 1

When to Seek Emergency Medical Care

Seek immediate ophthalmologic evaluation after initial irrigation for:

• Assessment of damage extent
• Checking eye pH
• Determining if additional irrigation is needed
• Evaluation for corneal damage 1

Emergency medical services should be activated immediately if:

• Respiratory symptoms are present
• Systemic symptoms develop
• Large areas are exposed to chemicals
• Burns involve face, hands, feet, or genitalia
• Full-thickness burns are suspected 1

Clinical Importance

Chemical eye injuries represent 10-22% of all eye injuries, and the extent of damage is directly related to both the chemical properties and exposure duration 2, 1. Early irrigation is strongly associated with reduced eye damage in both human observational and animal experimental studies 2. The length of time the chemical remains in contact with the eye determines the severity of the injury, making immediate irrigation crucial for preventing vision loss 3, 4.

Remember that chemical burn injury to the eye is a medical emergency that requires immediate intervention without unnecessary delay, as it is potentially sight-threatening and can lead to loss of the eye in severe cases 5.