Chemical Injury

Key history
Key examination
Initial management
Referral

Key history

• Which chemical (acid or alkali, liquid or particulate)
• Any initial first aid (has irrigation already occurred)

Key examination

IRRIGATE FIRST!

 Then examine more fully with:

• Visual acuity in both eyes
• Conjunctiva – normal, erythematous or abnormally white indicating damage to blood vessels
• Corneal clarity and epithelial defect

Initial management

• Copious irrigation with saline (topical anaesthetic first). At least 1 litre per affected eye
• Sweep fornix (under upper and lower lids) with moist cotton wool bud to remove any particles
• Continue irrigation if transfer delayed
• Check pH with urine dipstick and stop irrigation if pH is neutral

Referral = Urgent