CHEMICALS IN THE EYE


Symptom Definition: Chemical gets into the eye from fingers, contaminated object, spray or splash.
Background Information:
Harmless Substance:
Harmful Substances:
+ FIRST AID Advice for Chemical in the Eye.

Triage Assessment Questions for Chemical in the Eye

A. Go to ED NOW (or Office with PCP Approval)
Shortness of breath Reason: possible bronchospasm or pulmonary involvement

Acid or alkali was the chemical (as defined in Background Information)

  • (Exception: mild agents such as household bleach or ammonia - instead Call Poison Center)
+ First Aid: Irrigate eye immediately before going to the ED.
Sounds like a serious injury to the triage nurse  
B. Go to Office NOW
Cloudy spot or sore on the cornea (clear central part of eye) + First Aid: Irrigate eye immediately afterwards

Blurred vision that persists >1 hour after irrigation

R/O: corneal damage
Eye pain that persists > 1 hour after irrigation R/O: corneal damage
Continued tearing or blinking that persists > 1 hour after irrigation. R/O: corneal damage
C. Call Poison Center NOW
Possibly harmful substance in the eye (Exception: MACE, pepper spray, soap. sunscreen lotion or other obviously harmless substance) + First Aid: Irrigate eye immediately before calling Poison Center

Blurred vision that persists >1 hour after irrigation

R/O: corneal damage
Eye pain that persists > 1 hour after irrigation R/O: corneal damage
Continued tearing or blinking that persists > 1 hour after irrigation. R/O: corneal damage
D. See Today in Office
Redness persists >24 hours + First Aid: Irrigate eye immediately afterwards

Patient wants to be seen

R/O: conjunctivitis
E. Home Care
MACE or "pepper Spray" was sprayed into face/eyes + First Aid: Irrigate eye immediately afterwards

Eye irritation from harmless chemical

 
Home Care Advice for Harmless Chemical in the Eye

1. Irrigate the eye immediately.

2. Eye Irrigation Method #1 -- Flushing:

3. Eye Irrigation Method #2 -- Immersion:

4. Duration of Irrigation for Harmless Substances:

5. Vasoconstrictor Eye Drops: Red eyes from irritants usually feel much better after the irritant has been washed out. If they remain uncomfortable and bloodshot, use some long-acting vasoconstrictor eye drops (e.g. Visine). Use 1 to 2 drops. May repeat once in 8-12 hours.

6. Contacts: Patients with contact lenses need to switch to glasses temporarily. (Reason: to prevent damage to the cornea)

7. Expected Course: The pain and discomfort usually pass 1 hour after irrigation.

8. Call Back if:


This protocol generously contributed by David Thompson, MD. For more info, please click here to access the American Academy of Pediatrics website, and the link to Dr. Thompson's new book.



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