Chemical Spills

What you need to know and do if you have a chemical splash in your eye.

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Chemical burns are when a liquid or powder chemical makes contact with the eye. Most of the time, chemical eye injuries happen when a chemical splashes across a person’s face, though they can also result from rubbing your eyes after handling chemicals. The injury potential varies depending on the chemical involved, and one’s degree of exposure.

While most cases of chemical eye injuries do not result in permanent damage, it is critical that you treat every chemical in the eye as an eye emergency.

Injuries can range from minor, temporary redness and irritation to blindness and total loss of an eye. In rarer cases, chemicals which get into the eyes can also cause poisoning as they’re absorbed into the bloodstream.

Whenever handling chemicals in any form, be sure to wear appropriate safety gear, such as goggles or a face shield. 

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Immediate Treatment

If a chemical gets into your eyes, it’s important to immediately remove any contact lenses and flush the eyes with water for 15 minutes. In cases involving non-toxic chemicals, such as soap or shampoo, this will be sufficient to get it out of your eyes and prevent any serious damage. However, you should still seek medical attention even in these cases if irritation or other systems persist. If an acid or alkali chemical gets into your eyes, seek immediate eye care for chemical spills by calling your eye doctor's office or visiting the emergency room or urgent care facility if we are unavailable.

Types of Chemical Injuries

Types of Chemical Injuries

Young men are the most likely demographic to sustain chemical injuries to the eyes, and more than 90 percent of these injuries are the result of accidental exposure, generally in industrial settings.

Acid Burns

Acid burns are generally caused by exposure to acids with a pH of less than 4. Common acids encountered in emergency settings include sulfuric acid (which is found in car batteries) and hydrochloric acid (which is used for cleaning swimming pools.)

Acids are usually less destructive to the eyes than alkali substances, due to their tendency to denature, coagulate, and precipitate corneal proteins when they come into contact. This creates a barrier and keeps the acid from penetrating further. This coagulation creates the ground-glass appearance often seen on the cornea in severe acid burns. Among acids, hydrofluoric acid (which is found in anti rust solutions and glass etching solutions) is a more dangerous exception to this rule, as it more rapidly penetrates entirely through the cornea, causing significant damage to the cornea and the anterior segment.

Alkali Burns

Alkali chemicals such as sodium hydroxide, calcium hydroxide, and ammonia can be found in things like drain cleaners or industrial cleaning solutions, fertilizers and household cleaning solutions, and cement and plaster.

Because alkali chemicals are lipophilic, they penetrate through the cell membranes easily, and substances within these chemicals can denature the cornea’s collagen matrix to allow the chemicals to penetrate further. Tissues that come into contact with these chemicals may sustain a great deal of damage, and the chemicals can continue to penetrate the body long after the initial exposure.

This direct chemical damage can lead to significant, lasting damage to the eyes in a very short time, so it is extremely important to be careful and stay protected when around such substances.

Levels of Severity

Levels of Severity

Depending on a number of factors, the severity of chemical burns can vary greatly. At lower levels of severity, damage is minimal and most patients will experience a complete recovery. At the higher levels, there is much greater damage and potential for long-term damage, up to vision or eye loss, even with the proper treatment. It is highly recommended that you have a licensed eye doctor assess and treat chemical spills to the eye.

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Symptoms

While in most cases, someone who suffers a chemical burn to the eyes will be aware of it right away, it’s still important to be able to recognize the signs of such an injury, so that treatment begins quickly even in less severe instances.

Symptoms include:

  • A burning sensation
  • Stinging
  • Redness
  • Watery eyes
  • Pain
  • Swelling of the eyelids
  • Blurry vision

Additional Complications

Although the vast majority of chemical spills that require treatment do not lead to permanent injury, other, more serious, complications can arise. 

These include:

  • Corneal ulcer – superficial damage to the cornea
  • Corneal perforation – full thickness damage to the cornea, the clear surface of the eye
  • Glaucoma – high pressure within the eye, which damages the optic nerve
  • Cataracts – an abnormal clouding of the eye's lens
  • Retinal damage
  • Loss of the eye

Emergency Response

It’s vital that treatment of a chemical burn starts immediately at the site of the incident. The impacted eye(s) should be well irrigated with any available noncaustic fluid at the site of the injury and during transport to the hospital, urgent care, or eye doctors office. Additionally, any contact lenses should be removed as quickly as possible. Upon arriving at a qualified doctor, it’s important to tell the medical staff what chemical was involved, and especially whether it was an acid or an alkali.

Once in emergency care, irrigation should continue until the pH of the ocular surface returns to the normal range, between 7.0 and 7.2. pH strips can be used to check if the chemical has been completely removed. Prompt irrigation can help minimize the damage and long-term impacts. The level of pain experienced may not be a good indicator of the severity of the injury. Alkali chemicals, for example, may not cause immediately noticeable symptoms despite causing serious eye damage. Powder or particulate chemicals can cause more damage than a liquid, since they may be harder to flush out of the eyes.

Following the initial treatment, it’s important to receive a full eye exam, to confirm the location of the burn and to check how much damage there is. Other diagnostic tests can include a fluorescein evaluation, which uses a special dye which colors damaged or dead eye tissue yellow-green when under ultraviolet light.

Especially if there was damage detected, follow-up exams throughout the recovery process are important, to keep track of the treatment.

Types of Chemical Injuries
Levels of Severity

Treatment

Treatment will vary depending on the chemical involved and the severity of the burn, but may include:

  • Pain-relief medication
  • Medicated eye drops
  • Topical antibiotics (to reduce infection risk)
  • Lubricants, which are applied to the surface of the eye to keep the eyelids from sticking to the cornea during the healing process.
  • Specialized contact lenses may improve vision after a severe chemical burn 
  • Amniotic membranes may be used to treat severe burns
  • Anti-inflammatory medication

Even in less serious cases, be sure to follow your doctor’s advice regarding home care after the accident, make sure to return to follow-up checks, and if new symptoms arise, see your doctor right away.

Common Questions

Various chemicals can cause serious eye damage, posing significant threats to one's vision. Alkaline substances, like cleaning products, cement, and drain cleaners, are especially harmful, often causing more severe injuries than acids. Acids, such as hydrochloric acid, sulfuric acid, and nitric acid, can also cause significant harm. While household items might seem harmless, many contain chemicals that can be dangerous if they come into contact with the eyes. In any instance of potential chemical exposure, it's crucial to seek out an eye doctor immediately to address the situation.
It's essential to understand that not all eye drops are suitable for treating chemical burns. If a chemical substance comes into contact with the eye, the immediate action should be to rinse the eye thoroughly with sterile saline or clean, cool water for at least 15 minutes. This can help wash out the chemical and mitigate damage. Once you've rinsed the eye, it is crucial to see an optometrist as soon as possible. They can recommend specific treatments or eye drops tailored to the type and severity of the burn.
The best initial treatment when a chemical comes in contact with the eye is immediate and copious irrigation with sterile saline or clean, cool water. This should be done for at least 15 minutes, ensuring that the chemical is completely washed out. Blinking while rinsing can help remove the chemical from the eye's surface. Following this, seeking immediate professional care from an optometrist is vital. They can assess the extent of the injury, provide appropriate treatment, and recommend any necessary follow-up care.
Recovery from chemical burns varies depending on the type and concentration of the chemical, the duration of contact, and the promptness of initial treatment. Minor chemical injuries may heal completely with proper care, while severe injuries can lead to permanent damage or vision loss. Immediate and thorough rinsing followed by prompt evaluation and treatment by an eye doctor can significantly improve the chances of recovery. Continuous follow-up and care, including medications to promote healing and prevent complications, may also be necessary.
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Summary

Eye injuries caused by chemical exposure can potentially be very serious, especially in the event of alkali chemical burns. If chemicals make contact with your eyes, be sure to immediately flush the eyes with water, and seek medical attention. Prompt treatment can be vital for preventing long-term damage. Eye doctors are equipped to diagnose and treat burns from a chemical eye emergency, if your eye doctor is unavailable visit an emergency room or urgent care facility right away.

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