Eye injuries - chemical burns

A chemical burn occurs when a liquid or powder chemical comes into contact with the eye. Common culprits include household products as well as substances such as fresh concrete and hand sanitiser. Most often the injury happens when a chemical splashes onto the face, but it can also occur when you rub your eyes after handling a chemical.

Depending on the substance and the degree of exposure, the potential for injury ranges from temporary redness and irritation through to blindness and even loss of the eye. On rare occasions, chemicals splashed into the eyes can also cause poisoning, because they are absorbed into the bloodstream far more rapidly than chemicals splashed onto the skin.

For splashes of non-toxic liquids such as soaps or shampoos, flushing the eye with clean water is usually all the treatment you need. Splashes from acids or alkalis, however, are serious and may cause vision loss. Alkalis are especially dangerous to the eyes. The single most important rule is to rinse the eye thoroughly and seek urgent medical attention.

Symptoms of a chemical burn#

Symptoms depend on the substance involved, but may include:

• stinging or a burning sensation
• redness
• pain
• swelling of the eyelids
• blurry vision
• watery eyes

Complications of severe chemical burns can include corneal perforation (full-thickness damage to the clear front surface of the eye), corneal ulcer (more superficial damage to the cornea), cataracts (clouding of the eye’s lens), glaucoma (high pressure within the eye, which damages the optic nerve), retinal damage and loss of the eye.

First aid for a chemical burn to the eye#

Liquid or powder splashes from chemicals may seriously damage the eye. In many cases, prompt and thorough rinsing with saline or clean water dramatically reduces the risk of injury and lasting damage. It is often better to go straight to the nearest tap than to wait for saline from a first aid kit.

First aid suggestions include:

• Hold your face under running water for 15 to 20 minutes and let the stream flood into your eyes.
• Use your fingers to hold your eyelids apart, making sure there is no trace of the chemical on your fingers.
• If you wear contact lenses, remove them as soon as possible.

If anyone has collapsed, stopped breathing or is seriously unwell, call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) for an ambulance.

Seek immediate medical advice#

Medical staff will need to know what chemical was involved, in particular whether it was acid or alkaline and whether it was a liquid or a powder. Do not judge the seriousness of an eye injury by how much it hurts. Alkali chemicals, for example, often cause little pain yet can seriously damage the eye. Powder or granular chemicals, such as wet concrete, can be especially harmful because they are harder to flush out.

Diagnosis and professional treatment#

Professional care for a chemical burn to the eye may include:

• A full eye examination to find the location of the burn and assess the amount of damage.
• Irrigation, where the doctor or ophthalmologist flushes your eyes even if you have already rinsed them. pH strips can be used to check whether irrigation has removed all traces of the chemical.
• Diagnostic tests, which may include a fluorescein evaluation, where a special dye colours damaged or dead eye tissue yellow-green under ultraviolet light, followed by a review examination.

Treatment differs according to the chemical and the severity of the injury, but may include pain-relieving medication, topical antibiotics to reduce the risk of infection, medicated eye drops, anti-inflammatory medication, and lubricants applied to the eye surface to stop the eyelids sticking to the cornea as it heals. In more serious cases, hospital admission may be necessary and any complications are treated.

Self-care after a chemical burn#

Be guided by your doctor or healthcare professional. General suggestions include:

• Do not drive while wearing an eye patch.
• Use any medication strictly as directed.
• Attend all follow-up appointments.
• See your doctor or eye specialist straight away if you develop new symptoms such as eye pain, redness, intolerance of light (photophobia) or blurry vision.

Preventing chemical eye burns#

Estimates suggest that about 90% of chemical burns to the eye are avoidable. Always wear appropriate safety goggles or a face shield when handling liquid or powder chemicals. Wear eye protection every time, even for quick jobs.

Ordinary prescription glasses or sunglasses do not provide reliable protection, because their loose fit lets liquids or powder splash in behind the frames. Appropriate safety gear is the best way to reduce your risk of injury. Options depend on the job, but may include:

• Safety glasses, which look similar to regular glasses but have shatter-resistant lenses, stronger frames and side shields. They do not seal against the face, so liquids may still splash or run into the eyes. They may be enough where the risk of splash is low or the liquid is non-toxic.
• Safety goggles, made from smash-resistant materials that seal against the face and offer maximum protection against splash injury. Some styles are large enough to fit over prescription glasses.
• Face shields, recommended when handling especially dangerous materials such as corrosive liquids or powders, cryogenic fluids or biological materials. Goggles are sometimes worn underneath as well.

Other eye safety suggestions#

• Know your chemicals, check the label and understand the hazards.
• Choose safer products where you can. The same chemical may be available in a less dangerous form, for example as pellets rather than a liquid.
• Keep safety equipment in good repair and easily accessible. Safety goggles and face shields wear out, so replace them according to the manufacturer’s guidelines.
• Do not wear contact lenses when working with chemicals, as a lens can absorb a chemical and concentrate the burn on the eye surface. Wear prescription glasses instead, with protective equipment over the top.
• Dispose of unwanted chemicals safely.

If poisoning is involved or suspected, contact your local poisons information centre or emergency number for advice. In a workplace, your occupational health and safety representative and coordinator can also help with chemical safety.

Key points#

• Most chemical eye burns happen when a chemical splashes onto the face.
• Splashes from acids or alkalis are serious and may cause vision loss.
• Symptoms can include stinging, redness, pain, eyelid swelling, blurry vision and watery eyes.
• Alkali chemicals may cause few symptoms yet still seriously damage the eye.
• Appropriate safety gear is the best way to reduce your risk of injury.

Where to get help#