S M L

Emergency treatment of chemical eye injuries

Act immediately - every second counts

Stop whatever you are doing

Call other staff to help

Lie patient down

Open the eye

Squirt in lots of local anaesthetic (use xylocaine ampoules or anaesthetic eye drops)

Irrigate the eye thoroughly with water

Use tap water, water for irrigation or saline

Pour irrigating fluid from a jug, bottle or giving set

The eye must be open, the eyelids retracted and the patient looking straight ahead or down

Use a syringe or giving set to irrigate beneath the eyelids

If ringing for advice from on-call ophthalmologist, use a portable 'phone - don't stop irrigation

Continue irrigation for 30 minutes before transporting

Repeat anaesthetic drops every 5 minutes

Instil cyclopentolate drops every 5 minutes if available

Continue irrigation while transporting

All chemical injuries require immediate ophthalmic review

Pain. Keep using anaesthetic and cyclopentolate drops. Give 3 paracetamol tablets (1500mg) and consider IM or IV pain relief.

Panic. Ask parents to leave. Be very firm with uncooperative adults.

Eyelid closure. Use towels, cotton buds, a bent paperclip, lid speculum or Desmarres retractor to keep eye open.

Eye movements. To get patients to look straight ahead or down ask them to fixate an object or their own outstretched hand.

Infants. Swaddle and ignore crying.

Watery mess. Ignore, you are saving a persons sight.