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Chemical eye injuries

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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  • regarded as an ophthalmologic emergency
  • most are industrial and easily preventable by wearing protective goggles. However, injury from concentrated sulphuric acid or ammonia in criminal assault is not uncommon

  • effects are variable:
    • may include intense blepharospasm, uveitis, and corneal opacification Later there may be angle-closure glaucoma, cataract formation, entropion and keratitis sicca

  • injury due to alkali is more severe as it penetrates tissue more deeply and if untreated, will continue to cause damage long after the injury is sustained. By contrast, acid forms a barrier of precipitated tissue that limits penetration

  • Treatment:
    • immediate and copious irrigation with water is required; excrutiating pain may make it difficult for the patient to hold the eye open - the application of amethocaine drops every minute for five minutes will aid irrigation and relieve pain
    • topical antibiotics prevent secondary infection and steroids suppress inflammation
    • where the burn has been caused by acid or alkaline chemicals, litmus paper is used to indicate when the eye has been sufficiently irrigated

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