Chemical Splash in Eye: What to Do Right Now

Start flushing — now

The single most effective intervention for a chemical eye exposure is immediate, continuous irrigation with water. Every second before rinsing begins is a second the chemical continues to damage tissue — research consistently shows that the speed of irrigation is the most important factor in determining the outcome of chemical eye injuries 1Ref 1Wiesner N, Dutescu RM, Uthoff D, Kottek A, Reim M, Schrage N (2019).First aid therapy for corrosive chemical eye burns: results of a 30-year longitudinal study with two different decontamination concepts.Immediate irrigation as the most critical determinant of outcome in chemical eye injuries; alkali vs acid penetration depth; corneal assessment after rinsing2Ref 2Bore M (2018).Emergency management: chemical burns.36,000 annual US ED visits for chemical eye injuries; immediate high-volume irrigation protocol; contact lens removal during rinsing; emergency physician assessment of eye pH after irrigation.

How to flush: 1. Go to the nearest water source — a sink, shower, drinking fountain, garden hose, or eye wash station 2. Hold your eyelid open with your fingers — the instinct to keep the eye shut works against you 3. Let water flow across the eye from the inner corner (near the nose) outward, or submerge your face in a bowl of clean water and blink repeatedly 4. Continue rinsing for at least 15 to 20 minutes — this is longer than it feels 3Ref 3America's Poison Centers (2024).Splashed a Poison in Your Eye?.15–20 minute irrigation protocol; any clean water acceptable; call 1-800-222-1222 for guidance on chemical-specific next steps; when to seek urgent ophthalmologic evaluation 5. If one eye is affected, tilt your head so the contaminated eye is down to avoid washing the chemical into the other eye

Contact lenses should be removed during flushing if possible, but do not delay flushing to remove them 2Ref 2Bore M (2018).Emergency management: chemical burns.36,000 annual US ED visits for chemical eye injuries; immediate high-volume irrigation protocol; contact lens removal during rinsing; emergency physician assessment of eye pH after irrigation.

After flushing: call Poison Control and seek emergency care

Once irrigation has begun, call Poison Control: 1-800-222-1222 (US). They can advise whether the specific chemical requires additional steps and how urgently you need emergency evaluation 3Ref 3America's Poison Centers (2024).Splashed a Poison in Your Eye?.15–20 minute irrigation protocol; any clean water acceptable; call 1-800-222-1222 for guidance on chemical-specific next steps; when to seek urgent ophthalmologic evaluation.

After flushing, go to an emergency room or urgent eye care clinic for evaluation. Even if the eye looks and feels fine after rinsing, chemicals can continue to damage tissue that is not visible to you. An emergency physician or ophthalmologist will check the pH of the eye, assess the depth of any injury, and determine whether further treatment is needed 1Ref 1Wiesner N, Dutescu RM, Uthoff D, Kottek A, Reim M, Schrage N (2019).First aid therapy for corrosive chemical eye burns: results of a 30-year longitudinal study with two different decontamination concepts.Immediate irrigation as the most critical determinant of outcome in chemical eye injuries; alkali vs acid penetration depth; corneal assessment after rinsing2Ref 2Bore M (2018).Emergency management: chemical burns.36,000 annual US ED visits for chemical eye injuries; immediate high-volume irrigation protocol; contact lens removal during rinsing; emergency physician assessment of eye pH after irrigation.

Why alkalis are especially dangerous

Not all chemical exposures carry the same risk. Alkalis — substances with a high pH — penetrate eye tissue rapidly and continue damaging the interior of the eye long after the initial splash. Common alkali exposures include:

• Bleach / sodium hypochlorite
• Oven cleaner, drain cleaner (lye / sodium hydroxide)
• Lime, cement, plaster (calcium hydroxide)
• Ammonia-based cleaners

Acids — such as battery acid or vinegar — tend to cause more immediate, localized damage at the surface but are somewhat self-limiting because they do not penetrate as deeply 1Ref 1Wiesner N, Dutescu RM, Uthoff D, Kottek A, Reim M, Schrage N (2019).First aid therapy for corrosive chemical eye burns: results of a 30-year longitudinal study with two different decontamination concepts.Immediate irrigation as the most critical determinant of outcome in chemical eye injuries; alkali vs acid penetration depth; corneal assessment after rinsing. However, concentrated acids can still cause serious injuries and require the same emergency response.

Chemical eye burns account for up to 36,000 emergency department visits annually in the United States 2Ref 2Bore M (2018).Emergency management: chemical burns.36,000 annual US ED visits for chemical eye injuries; immediate high-volume irrigation protocol; contact lens removal during rinsing; emergency physician assessment of eye pH after irrigation. The bottom line: the category of chemical matters for prognosis, but it does not change the immediate action — rinse first, identify later.

What to tell emergency providers

Bring the container with you if safe to do so, or photograph the label. The treating team will want to know: - The exact chemical or product name - How much entered the eye and how long it was in contact before rinsing - How long you irrigated - Whether you wear contact lenses

Do not rub the eye at any point — rubbing can abrade the corneal surface and worsen damage 1Ref 1Wiesner N, Dutescu RM, Uthoff D, Kottek A, Reim M, Schrage N (2019).First aid therapy for corrosive chemical eye burns: results of a 30-year longitudinal study with two different decontamination concepts.Immediate irrigation as the most critical determinant of outcome in chemical eye injuries; alkali vs acid penetration depth; corneal assessment after rinsing.