Synopsis
Recognise chemical exposure as a time-critical ocular emergency, begin effective decontamination immediately, and assess persistent surface damage and limbal injury after irrigation.
- Time to irrigation is a major modifiable determinant of damage; clean tap water is suitable when saline is not immediately available.
- Use a gentle continuous flow, protect the other eye from runoff and remove contact lenses as soon as practicable without delaying flushing.
- Irrigate for at least twenty minutes initially and continue as required until surface pH remains physiological after a pause.
Key red flags
A cloudy cornea, blanched limbus or reduced vision after chemical exposure indicates potentially severe injury: continue decontamination and obtain immediate ophthalmology involvement.
Investigation priorities
Determine whether continued chemical contamination requires further irrigation.
Management branches
A credible chemical exposure is reported or contaminated material is visible around the eye.
- Start abundant gentle water or saline irrigation immediately while another team member calls for urgent assistance and obtains exposure information.
- Open the lids, use topical anaesthetic if promptly available, and remove accessible contact lenses during flushing without interrupting decontamination unnecessarily.
Key medicines
Proxymetacaine hydrochloride 0.5% eye dropsA clinician may instil one or two drops topically for a brief ocular procedure; repeat only according to the supervised procedural requirement.