Chemical Burn in Your Eye: How to Treat

A chemical burn in the eye is a major injury and of great concern. Some chemicals can penetrate deep into the structure of the eye and cause permanent damage.

Depending on the substance and how long it stays in your eye, you may experience anything from minor irritation to complete vision loss. In some cases, you can even lose the eye.

If you get chemicals in your eye, you’re likely to feel:

• a burning sensation
• stinging
• tearing
• pain
• redness of the eye and eyelid
• blurred or reduced vision
• light sensitivity
• trouble keeping your eyes open

While some chemicals can cause severe eye pain, minor symptoms don’t necessarily mean there’s no damage to the eye.

How serious an ocular chemical burn is may depend on the time since the burn first happened, and the staging or classification of injury can dictate what kind of treatment is needed.

You can have eye damage because of chemicals in solid, liquid, powder, or aerosol products such as:

• soaps
• disinfectants
• solvents
• nail polish remover and cosmetics
• general cleaning products
• drain and oven cleaners
• laundry and dish detergents
• bleach and ammonia
• fertilizers and pesticides
• battery acid
• vinegar

The two most common types of ocular chemical burns are:

• Alkali burns: These are caused by a water-soluble (high pH) base compound commonly found in drain cleaners or industrial cleaning chemicals. Alkali burns are far more dangerous to the eye because tears can’t move through high pH agents, allowing the alkali to penetrate deep into the eye and cause extensive tissue damage.
• Acid burns: These are caused by low pH chemical exposure such as hydrochloric acid found in swimming pool cleaner or sulfuric acid that’s found in car batteries. Human tears can quickly move through these acids and neutralize the low pH, which will limit the chemical penetration and tissue damage.

This 2016 study reports that 53.6% of eye-related burns occur because of alkali burns, compared with 46.4% from acid burns.

A 2019 review article found that immediate flushing of the eye is the most important thing you can do. Thorough flushing is an effective way to lower the severity of the burn, as well as the need for surgery, even before a doctor examines the eye.

Avoid the temptation to rub or put pressure on your eye, which can make matters worse. If you’re wearing contact lenses, don’t try to remove them just yet. Wash your hands to remove any remaining chemicals.

Older research from 2014 suggests that you should flush the eye for no less than 10 minutes. Here’s how:

• Use a continuous stream of cool, lukewarm, or room temperature water. Running tap water is fine. You can hold your head under the faucet, but it might be easier to step into the shower, especially if both eyes are affected.
• Use your fingers to keep your eyes open.
• Let the water flow gently over the eye from the forehead.
• If only one eye is affected, turn your head so the water runs away from the unaffected eye.
• After a few minutes of rinsing, you can try to remove contact lenses. But be careful not to rub or scrape your eyeball.
• If possible, keep rinsing for 15 to 20 minutes.

Once you’re in a medical setting, a doctor might use anesthetic eye drops before testing the acidity (pH) level in the eye. Rinsing will continue until the pH level approaches normal.

Next, the doctor will likely use drops to dilate the pupil and assess the injury. Dilating eyedrops can also relax the internal smooth muscles and ease pain.

A topical antibiotic can help lubricate your eye and prevent infection, and a topical steroid can help lower inflammation. In severe cases, you may need a bandage over your eye to keep it closed. Other treatments may include preservative-free artificial tears and pain relievers.

After initial treatment, you’ll get a referral to an ophthalmologist. These are doctors who specialize in treating eye diseases and preventing complications.

Following up as recommended will provide the best chance of avoiding more serious problems.

When injuries are severe, surgery may be needed.

Don’t use over-the-counter eye drops, which could make matters worse.

Get the go-ahead from a doctor before putting anything in your eyes.

If a doctor recommends or prescribes eye drops for this injury, use them exactly as directed.

Depending on the extent of your injury, you’ll likely have several follow-up visits with a doctor. Everyone is different and healing time varies based on:

• the type of chemical
• how long it stayed in your eye
• how quickly you were able to start treatment
• extent of the damage to your eye

You might feel back to normal within days or weeks. Most people have a complete recovery. However, complications can include:

• chronic eye pain
• dry eye syndrome
• glaucoma
• damage to the cornea
• cataracts
• blindness
• loss of the eye

If you have complications, you’ll likely need other treatments over time.

Chemical burns to the eyes are totally preventable with the use of protective eyewear or goggles whenever you’re handling potentially toxic substances or when exposed to their presence.

Getting chemicals in your eyes is a medical emergency. Early symptoms don’t always match the severity of the injury. If it happens to you, start rinsing your eyes with water right away. The longer a chemical remains in your eye, the more likely it is to cause serious damage. Be sure to have a doctor examine your affected eye as soon as possible. Make sure a doctor knows what substances were involved. While most people recover, some chemical burns lead to permanent vision loss or loss of the eye.