Chemical Eye Injuries: Why Rinsing Time Matters for Healing

Anders Behndig is a professor and senior consultant at Umeå University Hospital and an expert on the front part of the eye. During his years as an eye specialist, he has met several patients who have had the misfortune of getting corrosive substances into their eyes, either at work or at home. And it is the patients who have had the opportunity to quickly rinse their eyes that have fared the best.

“The most important thing when you get a corrosive substance in your eye is to start rinsing the eye immediately. It is a matter of seconds after the injury has occurred, and it is important to keep rinsing for a long time. This is crucial for determining whether the eye and vision can be saved.”

“The amount of liquid used to rinse the eye is of great importance for how quickly a corrosive substance is diluted and the pH is restored. The flow of liquid is also crucial for the purely mechanical removal of the corrosive substance from the eye, especially if it contains solid particles, which is not uncommon. A high flow cannot be achieved with, for example, spray bottles or similar devices; instead, a strong, continuous flow of liquid is required to achieve the intended effect,” says Anders Behndig.

Buffered is best

The best thing to use is a so-called buffered rinsing solution. This is a solution that neutralises the pH in the eye more quickly than regular water or saline solution.

“If you get a strong corrosive substance in your eye, it is not enough to just rinse it with water or saline solution, because this only has a mechanical effect. A buffered solution also neutralises the pH and helps return it closer to the eye’s natural pH,” says Anders Behndig.

If you have the misfortune of getting a dangerous substance in your eye, how do you know if it is permanently damaged?

“You can’t know this straight away. It can take days, sometimes weeks, before you can know how badly damaged the eye is. This is partly because the healing process after damage caused by an alkaline substance is what we call ‘biphasic’: the eye first becomes inflamed and red, then it can calm down after a few days and appear better, only to worsen significantly again,” says Anders Behndig.

Time is of the essence

Chemical eye injuries can destroy, in whole or in part, the biological tissues of the eye. This can result from extreme pH levels or from substances with oxidising or reducing properties.

“The worst injuries occur after accidents involving alkaline substances, as they can penetrate deeply and damage the eye’s stem cells so that the cornea becomes cloudy and unclear, or they damage the conjunctiva so that adhesions form between it and the eyelid. This cannot be repaired with transplantation. Fortunately, these stem cells are deep enough that you can rinse away the dangerous substance before it damages them, allowing the eye to heal. It all depends on how quickly you start rinsing!”

Text: Karin Cedronius