Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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Chemical exposure needs immediate irrigation
A chemical splash can continue damaging the ocular surface while a history, visual-acuity test or referral is being arranged.
Action: Begin copious irrigation immediately with clean water or available appropriate irrigation fluid, continuing for at least 20 minutes while urgent help is arranged. Do not wait for a preferred solution or complete examination. Remove contact lenses if this can be done promptly without delaying irrigation. Continue further when required: in clinical care, irrigation is guided by ocular-surface pH and repeated checks after a pause.
Synopsis
Use symptoms, visual function and exposure history to identify dangerous red-eye presentations, prioritise time-critical first actions, and make an effective urgent ophthalmic referral.
Measure visual acuity in each eye with usual correction when feasible, but never delay chemical irrigation or another immediate protective action.
Pain, photophobia and persistent blur should not be explained away by a familiar diagnosis of conjunctivitis or dry eye.
Ask about lenses, trauma, chemicals, recent surgery or injections, immunosuppression and current eye drops early in the assessment.
Key red flags
Pain with marked photophobia or sustained reduction in visual acuity requires urgent assessment for corneal or intraocular disease.
Investigation priorities
01
Visual acuity in each eyeFirst step
Quantify the functional deficit and support clear communication.
Management branches
Chemical injuryIrrigate before completing the assessment
A chemical has entered the eye and ongoing exposure may continue tissue damage.
Start copious irrigation immediately using clean water if the preferred clinical fluid is not already available.
Continue for at least twenty minutes while urgent assessment is arranged, removing a contact lens only if doing so does not delay flushing.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.