Evidence informing the guidelines

2020 First Aid Guidelines

Eye injury from chemical exposure

Accidental exposure of the eye to chemical substances is a common problem in both the
household and industrial setting and it is often difficult to identify precisely what chemical has
entered the eye. [In addition to accidental and occupational exposure, number of patients
victims of violent assault when acid is thrown on their face increased, resulting in life-changing
cutaneous and ocular injuries (7)].The extent of the ocular surface damage is influenced by the
type, temperature, volume, and pH of the corrosive substance and duration of exposure (4).
Alkali injury to the cornea has been shown to cause severe corneal injury and increase the risk
of blindness (6). In contrast, acidic substances cause protein coagulation in the epithelium, a
process that limits further penetration into the eye(8). Eye irrigation must be instituted
immediately at the scene of exposure and continued in the emergency department to reduce the
risk of visual impairment (4). It is recommended that the first aid provider should flush the eye
with adequate volumes of Previn® (Diphoterine®) immediately after the injury has been
sustained as it has shown a tendency for less severe burns following irrigation than any other
rinsing solution() and to refer the patient to an emergency healthcare system for complete
removal from the eye by true decontamination. However, if unavailable any safe, available
aqueous solution should be used for rinsing in a high flow rate, as the choice is less important
for the prognostic than the timing of treatment and any delay in irrigation should be avoided.
Where there is a known high risk of eye contamination by particular chemicals, specific
antidotes should be readily available.

2020 First Aid Guideline

In case of eye injury due to exposure to a chemical substance take immediate action. Put on
disposable gloves. Contact lenses and contaminated clothing should be removed and
discarded, as they may retain particle(2) Irrigate the eye using continuous, large volumes of
clean water. Take care that the rinsing water does not come into contact with the other eye
(Good Practice Point). Call 112 and the Poison Control Centre. Wash your hands after giving
first aid. Refer the individual for emergency healthcare professional review (Good Practice
Point).