James Wymore, M.D. Eye Surgeons Associates
It's not uncommon to have various chemicals from the environment find their way into the eyes. Most of the time, this is fortunately a minor event. For instance, using hand sanitizer, which has become very popular since COVID, and then rubbing your eye before it's fully evaporated. The eyes feel irritated, tear, and may be reddened for a while, but soon feel normal with no residual damage. Small amounts will typically have no lasting effects especially if rinsed with water or over the counter tears. If a large amount of hand sanitizer is squirted or splashed in the eye with a high concentration of alcohol more serious complications can arise. Rinse your eyes with water or over the counter tears. If irritation persists, contact your eye doctor.
Typically, one can divide chemical injuries into two major groups, acidic and alkaline. Acidic injuries are usually the least severe as just the most superficial tissues of the eyes tend to be affected. Examples of acids that have been involved in ocular damage include, the sulfuric acid found in battery acid and industrial cleaners, sulfurous acid in bleach, and acetic acid in vinegar.
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Alkalis are much more dangerous because of their penetrating characteristic. Instead of just damaging outer surfaces that may heal without scarring, they can harm crucial structures of the eye that will permanently affect the visual or other functions of the eye. Common alkalis include ammonia in fertilizers or cleaning solutions, lime found in plaster or cement, and magnesium hydroxide which is a component of sparklers.
Severe damage from any chemical, but particularly the alkalis, can scar the ocular coat causing decreased vision and dry eye problems. With deeper penetration, parts of the inner eye can be reached leading to problems such as cataract or secondary glaucoma.
In chemical injuries, the first and most important therapy is immediate irrigation of the eye. Damage is related to the amount of chemical and duration of exposure, so quickly and continuously washing it from the eye is crucial. After irrigation, or if possible, during it, it is important to get to an eye doctor's office or emergency room for evaluation and further definitive treatment (which will likely include irrigation).
When the eyes are examined, any foreign material will be removed. The extent of injury is assessed. It may be limited to mild abrasions which heal rapidly, needing only antibiotic coverage. The more severe the damage, the more likely other medications such as steroids, lubricants, or glaucoma drops will be necessary. Surgical procedures are available to repair the ocular surface, including a corneal transplant if the cornea is opacified enough to hamper vision.
Not all eyes can be successfully treated, so avoidance of chemical injuries by using safety glasses when using these chemicals is absolutely the best way to maintain healthy eyes. Appropriate protective eyewear can prevent more than 90% of serious eye injuries. If it does happen, immediate and copious irrigation to remove and dilute the attacking agent is the next best thing. Irrigating facilities are present at many work sites. If one is working around dangerous substances without these facilities, even just keeping bottles of water handy would be wise.
Dr. James Wymore, with Eye Surgeons Associates, is a board-certified general ophthalmologist. He is a member of the American Academy of Ophthalmology. He practices at an office in Rock Island. For more information, check the website: www.esaeyecare.com.
The material contained in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider.
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