Chemical Burn

  • Damage to eye by contact with toxic chemical
  • Symptoms usually temporary
  • Alkali-containing compounds (household cleaning fluids, fertilizers pesticides) can cause enough damage to turn cornea opaque
  • Acid-containing compounds (battery fluid, chemistry labs) cause less damage than alkali, but still dangerous
  • History of chemical exposure
  • In mild cases, pain, tearing, and conjunctival redness
  • In severe cases, pain, tearing, cornea surface erosions, corneal opacification, and blanching of conjunctival vessels
  • Instill topical anesthetic if patient will not open eyes because of pain
  • Irrigate with handiest source of water for about 10-15 minutes (squeeze bottles or saline drip bottles)
  • Use fingers, speculum, paper clip retractors to pry lids apart for best irrigation and removal of particles with cotton-tipped applicator
  • Measure visual acuity
  • Instill fluorescein dye to check for epithelial defects
  • Refer to ophthalmologist if acuity is subnormal, or there are epithelial defects
  • Most chemical burns leave no harm
  • Alkali (and acid) burns may cause permanent corneal damage
  • Early irrigation helps
  • In badly damaged eyes, specialized ophthalmologic treatment may be necessary, including corneal transplantation with special (Boston) keratoprosthesis