Chemical or thermal eye burn

An eye burn by chemical substance is any injury that occurs in any part of the ocular system due to exposure to chemical products. Although the eyelids close very quickly to protect the eye from harm, sometimes irritating or harmful chemicals reach the eye surface and cause burns.

Severe chemical burns involving the clear area of ​​the eye’s surface (cornea), especially alkali injuries, can lead to scarring injury, perforation of the eye, infection, and blindness.

Eye burns are very painful. Because the pain is so great, the affected person tends to keep their eyelids closed. Closed eyelids keep the substance against the eye for a long time, which can aggravate the damage.

Classification of ocular chemical burns

Chemical eye burns fall into three categories depending on the acidic or basic level of the substance, measured by pH. The pH scale runs from 0 to 14 and indicates how acidic or basic a substance is. A pH of 7 is neutral; the pH of healthy tears is 7.5. A pH less than 7 is acidic, while a pH greater than 7 is basic.

The three categories of burns are:

• Basic substance burns: These burns are caused by chemicals with a high pH and, therefore, they are the most dangerous. They are powerful enough to pass through the eye and cause damage to its vital internal components. In the worst cases they can trigger cataracts and glaucoma and blindness.
• Acid burns: Burns from low pH chemicals are less severe than those from basic substances, but are still dangerous. They cannot penetrate the eye; however, they can cause considerable damage to the cornea, with possible loss of vision as a result.
• irritations: produced by substances with neutral pH.

What can cause an eye burn?

chemical burns

As I mentioned before, chemical burns The most dangerous for the eyes are those produced by alkaline substances and strong acids.. Burns from the former tend to be more severe than those from the latter Alkaline substances include caustic soda and are most commonly found in lime products, concrete, plaster and mortar, oven cleaners and plungers, dishwasher detergent, and fertilizers .

Burns can be caused by splashing liquids or, less frequently, by powdered material that, dissolved in the air, reaches the eyes. Below you will find an exhaustive list of chemicals that are dangerous for the eyes:

• Ammonia, bleach, bathroom cleaners, and drain cleaner
• Vinegar, glass cleaner, and oven cleaner
• Gasoline and car battery fluid
• Chemicals present in cement and plaster
• Products to remove rust
• Hydrochloric acid
• Fireworks
• pesticides and fertilizers

thermal burns

In the case of thermal burns, the blink reflex often causes the eye to close in response to heat and therefore thermal burns tend to affect the eyelid instead of the conjunctiva or cornea. Thermal burns of the conjunctiva or cornea are usually minor and may not cause any permanent damage to the eye.

Signs and symptoms of an eye burn

The damage caused to the eye will depend in the first place on the type of chemical product that will come into contact with the eye and burn it. Afterwards, the importance of the damage will depend on the quantity and the time that the product was in contact with the eye.

Symptoms of an eye burn are:

• Blurred vision or vision loss
• Eye pain when you look at the light
• watery or red eye
• Swollen or twitching eyelid
• Cuts, blisters, or other damage to your eye
• dilated pupil
• cloudy eye tissue

How is an eye burn diagnosed?

Your doctor will ask about your symptoms, when they started, and what chemicals you were using when you had your burn. Once you are sure that your eye does not contain any more traces of the chemical product thanks to the rinse, your vision and the movement of your eye will be examined. You may also need to have any of the following tests:

• Litmus Paper Test: Also known as a pH paper test. He or she will put a small piece of paper on the bottom of your eyelid to see if there is still any of the chemical in your eye.
• Slit lamp examination: During this test you will look at the surface of your eye in detail to determine if there is an injury. It will also allow you to see if there is still any chemical residue left in the eye.
• Visual acuity test: This test checks your vision and determines if there has been any loss of vision.
• Fluorescein eye stain test: This test uses a blue dye and light to show damage to your eye.
• Tonometry: This test measures the Intraocular pressure to see if the chemical has been able to cause an increase in it, something that could be potentially dangerous for your vision.

What to do if I get a chemical in my eye?

Eye burns are very painful. Because the pain is so great, the affected person tends to keep their eyelids closed, causing the chemical to remain in contact with the eye for a long time, which can aggravate the damage.

Because, the first thing to do in case a chemical comes into contact with the eye is to rinse it immediately. The sooner you can begin flushing your eye, the less damage and the greater the chance of recovery. Call 112 (or the emergency number in your country) and keep rinsing your eyes until help arrives.

• Flush the eye with a steady stream of water or saline for at least 30 minutes. Use the cleanest water you can find. Never use other chemicals to rinse your eye. Irrigation should be started at the scene of the accident and continued in the ambulance and in the emergency room.
• In the event that the pain causes the patient to close the eye, another person should help by holding the eyelid open manually while the irrigation of the eye continues.
• Move your eye in all directions to make sure all parts of your eyeball are flushed. If possible, continue to flush your eye with water until you get medical help.
• Take off clothing that may still contain chemicals. However, if you were wearing contact lenses, do not remove them without medical supervision.
• If possible, take with you all the information about the product with which you suffered the accident, if it was a product that was inside a container, take it to your doctor so that he can see it. However, do not carry the product (or its packaging) if this implies a risk of re-burn.

How does an eye burn heal?

chemical burns

Minor burns that are quickly treated in most cases they heal in a few days.

eye care:

As I mentioned before, during your first post-burn visit the doctor will continue to flush your eye to make sure there are no chemical residues or other objects left in your eye.

In an emergency department, a special irrigation device that looks like a large contact lens is often used. The device is placed under the eyelids and connected to a bag of sterile saline. The saline solution drips out of the device and irrigates the eye.

The inside of the eyelid is also washed to remove any tiny particles that were not visible.

Medicines:

• Antibiotic: They help prevent an infection caused by bacteria. It can be administered as an eye drop or ointment.
  • Analgesics: They help eliminate or reduce pain. Do not wait until the pain is very bad to take the medicine. This medicine can also be given as eye drops. Although these anesthetic drops relieve pain, they also slow the healing process and are not usually given after the initial irrigation.
  • Cycloplegic drug (such as cyclopentolate or homatropine): which dilates the pupil, relaxes the eye muscles and prevents the appearance of painful spasms.
  • steroids: Reduces inflammation.

Surgery:

• debridement: Doctors remove any injured tissue from the eye to decrease swelling and help the eye heal.
  • Tenoplasty: Doctors reconstruct the damaged parts of the eyeball and restore the surface of the eye.
  • tissue graft: Doctors replace damaged eye tissue with new tissue.
  • Transplant: Doctors replace the injured cornea or other parts of the eye that have been damaged beyond repair.

thermal burns

Eyelid burns are treated the same as other skin burns. These burns are cleaned and then an antibiotic is applied to prevent infection. Burns to the conjunctiva or cornea can be painful, so those affected may need pain relievers. Cycloplegic drops (such as cyclopentolate or homatropine) may also be given to prevent painful spasms of the muscles that constrict the pupil, as well as antibiotic ointment to prevent infection.

What are the side effects of burn treatment?

• The process of flushing your eye can be painful.
• Steroid medicine can be harmful to your eye.
• You can get an eye infection.
• Surgery can cause permanent dry eyes.
• Your eye may be scarred, cut, or permanently damaged.
• Your vision may worsen or even go blind.
• Without treatment, your eye may develop cataracts (opacity of the lens) or glaucoma (increased pressure).

How to prevent eye burns?

• Always wear protective glasses. Use models that meet all the approval criteria and fit perfectly around your eyes.
• Don’t touch your eyes when you are working with chemicals. As my optometry professor used to say: “If your eye itches and you want to scratch it, do it with your elbow!”
• Follow the safety instructions strictly indicated by the manufacturers on the packaging of the chemical products to be used.
• Have an action protocol defined in case you or someone you work with gets burned. Where to find water or liquid to rinse your eyes, health care number, people trained to intervene,…. When it comes to having good eyewash liquid on hand, today you can find it in a super simple way, for example on Amazon where you can find emergency eyewash kits like this one: Portable Emergency Eyewash

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