Management of Eye Irritation After Chemical Exposure

Initial Management of Chemical Eye Exposure

Decontamination by irrigation should be performed immediately after chemical exposure to the eyes to minimize tissue damage, using continuous, large volumes of clean water, and unless otherwise recommended by local guidelines, irrigation with a copious amount of tap water for at least 15 minutes should be performed, as recommended by the American Heart Association 1, 2, 3, 4, 5
When providing first aid for chemical eye injury, avoid contaminating other individuals, areas, or the unaffected eye with the caustic substance, to prevent further injury 3, 5

Tap water is effective and readily available for emergency eye irrigation, and if immediately available, eye irrigation with normal saline, Ringer's lactate solution, or a commercial eye wash solution is reasonable, according to the American College of Cardiology 1, 3, 5

The definitive endpoint for irrigation is when a healthcare professional evaluates the injury and determines that the pH of the eye has returned to normal, as stated by the American Heart Association 2, 4

For industrial chemical exposures, adhere to local guidelines or recommendations from a poison center, and some chemicals such as hydrofluoric acid and phenol may require specialized decontamination approaches beyond water irrigation, as recommended by the American College of Cardiology 1, 3, 5, 6

For chemical eye injuries, immediate irrigation with large volumes of clean water is recommended to restore normal pH, as suggested by the American Heart Association, based on guidelines from Circulation 7
Delays in obtaining tear fluid pH measurements can artificially increase the measured pH value, according to the British Thoracic Society, as reported in Thorax 8