Eye Emergencies 2: What To Do Before You See A Doctor

Chemical Injuries
These are injuries caused by chemical exposure or the actual presence of chemical substances in the eye. They could be in liquid or vaporised form but are rarely solids. They are sometimes corrosive and could cause severe or moderate damage to the eye depending on the following:

1. The nature of the chemical;
2. The time or duration of exposure;
3. The amount of the chemical substance in contact with the eyes;
4. The chemical composition and its concentration.

Chemicals range from substances as mild as detergents, liquid soap, perfumes to substances as corrosive as battery acids. Furthermore, we could classify chemicals based on their pH value into 3 groups or classes;
1. Acids
2. Alkalis
3. Irritants

The pH scale ranges from 0-14. Neutral value is 7. Substances with values from 7 to 14 are termed Alkalis while substances with values below 7 are termed Acids. Irritants are those substances with neutral pH values of 7.

The most dangerous chemicals to the eyes are the alkalis. They cause more sight threatening and permanent damage because they have the ability to penetrate the deeper tissues of the eye such as the Lens and the anterior segment. Acids, however, cause merely superficial damage to the surface structures of the eye such as the cornea. This may also be sight threatening. Irritants, on the other hand, may be neutral but they have the capacity to irritate the highly innervated cornea and vascularised sclera.

We will group chemical substances into the 3 classifications listed above.

Acids: Examples of common acids are:
• Sulphuric acid (found in car battery fluids and drain cleaners or uncloggers),
• Hydrochloric acid (found in toilet bowl cleaners, rust removing products and some industrial tile cleaners),
• Hydrofluoric acid (found in glass polish),
• Sulphurous acid,
• Nitric Acid (found in some dye products),
• Acetic acid (found in vinegar and nail polish removers)

Alkalis: Examples of common alkalis include:
• Hydroxides of ammonia (found in harsh cleaning products like window cleaners, floor waxes, and oven cleaners),
• Lye (also known as Sodium hydroxide or caustic soda. It may be found in drain cleaners, some soaps and hair relaxers),
• Potassium hydroxide,
• Magnesium (found in some dye products),
• Lime (found in cement, lime, plaster),
• Fertilizers,
• Bleach

Irritants: Examples of common irritants include:
• Pepper spray,
• Detergents,
• Liquid soap,
• Perfumes or body sprays,
• Air fresheners,
• Aerosols.

Symptoms experienced in the event of a chemical exposure may include but is not limited to the following:
1. Varying degrees of redness
2. Irritation
3. Mild to moderate pain
4. Pepperish sensation
5. Swelling
6. Excessive tearing or lacrimation

FIRST AID FOR CHEMICAL INJURIES
Immediate action must be taken in the event of a chemical burn or exposure. The aim is to ensure that the chemical is completely removed from the eyes.
• Irrigate the eyes with an eye wash. This can be gotten from any medicine store or pharmacy. Where an eye wash is not readily available, use cool running tap water for about 15 to 30 minutes to flush out every trace of the chemical. This will help to neutralize, dilute and reduce the amount of chemical in the eye thus preventing further damage to the eye and its structures.
• It is better to irrigate for too long than for not long enough. No matter how uncomfortable the victim might be, do not stop irrigating especially for alkali burns.
• The eyes should be wide open and the eyelids lifted while flushing to ensure the chemical is totally removed.
• Ensure that the victim’s hands are washed and free of chemicals to avoid re-contamination of the eyes. If the chemical was in contact with other parts of the body the victim should wash thoroughly under the shower with his/ her clothes on to ensure that the chemical is completely diluted and removed.
• If the patient has contact lenses in the eye, flush until the lenses are flushed out.
• Keep flushing and seek professional eye examination.
• Take the packaging or leaflet of the chemical which got into the eyes and show it to the doctor. This will help the examiner to know the actual nature, composition and possible concentration of the chemical in contact with the eyes and the possible treatment regime to adopt.

CAUTION
1. Do not rub the eyes or apply any form of pressure to the eye or the globe.
2. Ensure proper hygiene when handling the eye. Hands and materials in contact with the eye must be clean and free of dirt.
3. Do not apply any substance apart from water into the eyes in a bid to neutralize the chemical (whether acid or alkaline) until proper examination by an eye doctor.

Watch out for the next episode!!!

Until then, be proactive about your eyes.

Cheers!!!

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