What is the role of irrigation in the treatment of chemical burns to the eye?

Updated: Oct 08, 2019
  • Author: Mark Ventocilla, OD, FAAO; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Immediate copious irrigation remains the single most important therapy for treating chemical injuries. If available, the eye should be anesthetized prior to irrigation.

Ideally, the eye should be irrigated with a sterile balanced buffered solution, such as normal saline solution or Ringer's lactate solution. However, immediate irrigation with even plain tap water is preferred over waiting for the ideal fluid.

The irrigation solution must contact the ocular surface. This is best achieved with a special irrigating tubing (eg, Morgan lens) or a lid speculum. Irrigation should be continued until the pH of the ocular surface is neutralized, to a range of 7.0-7.2, usually requiring 1-2 liters of fluid. Monitor the pH at 15- to 20-minute intervals after stabilization to ensure that no further particles are present to continue changing the pH. Once irrigation is finished, a complete thorough eye examination should be performed. Care should be taken to examine the fornices and under the upper lids via tarsal eversion for residual particles.


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