In any chemical or firecracker-related eye injury, irrigation is the treatment that matters most and should start before anything else. Alkali injuries continue to penetrate after the initial exposure.
Check the conjunctival pH with litmus paper before and after irrigation, and continue until it returns to neutral. Sweep the fornices for retained particles.
- Start irrigation immediately with whatever clean fluid is available
- Instil topical anaesthetic to allow effective irrigation
- Check pH after irrigation and repeat until it is neutral
- Evert the lids and sweep the fornices for particles
Why it matters
Every minute of delayed irrigation in an alkali injury increases the risk of permanent damage.
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