What is the treatment for a subconjunctival burn from a cooking oil splash?

Treatment of Subconjunctival Burn from Cooking Oil Splash

Immediately irrigate the eye with copious amounts of clean running tap water for 5-20 minutes, then apply preservative-free lubricating drops (hyaluronate or carmellose) every 2 hours, and refer urgently to an ophthalmologist for same-day evaluation. 1

Immediate First Aid Management

Irrigation Protocol

• Begin immediate irrigation with large amounts of clean running tap water as soon as possible after the injury 1
• Continue irrigation for 5-20 minutes to remove residual oil and reduce thermal damage 1
• Tap water is the recommended first-line irrigation fluid for ocular burns and is superior to waiting for specialized solutions 1

Post-Irrigation Care

• Apply preservative-free lubricating eye drops (hyaluronate or carmellose) every 2 hours to maintain corneal epithelial integrity and provide comfort 1
• These lubricants should be continued throughout the acute phase of injury 1

Urgent Ophthalmology Referral

All thermal burns to the eye require same-day ophthalmology evaluation to assess for:

• Corneal epithelial defects (using fluorescein staining) 1
• Depth and extent of conjunctival and corneal injury 1
• Presence of corneal ulceration or stromal involvement 1
• Risk of secondary infection 1

Ophthalmologist-Directed Treatment

Daily Ocular Hygiene

• Daily examination and irrigation with saline to remove inflammatory debris should be performed by an ophthalmologist or ophthalmically trained nurse 1
• Application of topical anesthetic (proparacaine or tetracaine) is necessary before this procedure 1

Topical Corticosteroids

• Topical corticosteroid drops (preservative-free dexamethasone 0.1%) may reduce ocular surface damage when supervised by an ophthalmologist 1
• These should be used cautiously and only under ophthalmologic supervision, as they can mask signs of corneal infection 1

Antibiotic Prophylaxis

• Broad-spectrum topical antibiotic prophylaxis (such as moxifloxacin or levofloxacin four times daily) is recommended if corneal fluorescein staining or frank ulceration is present 1
• Choice should be guided by local antimicrobial resistance patterns 1

Pain Management

• Over-the-counter analgesics (acetaminophen or NSAIDs) are appropriate for pain control 1

Critical Pitfalls to Avoid

• Do NOT delay irrigation to search for specialized solutions—tap water is effective and immediately available 1
• Do NOT apply ice directly to the eye—only use if clean running water is unavailable, and then only wrapped in cloth for superficial burns with intact skin 1
• Do NOT use topical corticosteroids without ophthalmology supervision, as they can mask infection and worsen outcomes 1
• Do NOT perform blind sweeping of the fornices with cotton swabs or glass rods, as this may cause additional damage 1

Follow-Up Strategy

• Daily ophthalmologic review is necessary during the acute illness to monitor for complications including infection, corneal ulceration, and progressive scarring 1
• The frequency of subsequent follow-up depends on severity of initial injury and response to treatment 1