In any chemical or suspected chemical eye injury, start copious irrigation immediately, before taking a full history, measuring acuity or referring. Instil topical anaesthetic, hold the lids open and irrigate with saline or clean water for at least 15–30 minutes.
Check the pH of the conjunctival sac and continue until it is neutral. Sweep the fornices and evert the upper lid to remove retained particles, which are common with lime and carbide.
- Begin irrigation immediately, before history or acuity.
- Use topical anaesthetic and a lid speculum or retractor to irrigate properly.
- Continue until the conjunctival pH is neutral.
- Evert the upper lid and sweep the fornices for retained particles.
Why it matters
Minutes of delay in alkali injury can mean permanent limbal damage.
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