Chemical Eye Injury: Pathogenesis and clinical findings

Exogenous chemical to the eye and/or adnexa

 • Ammonia, sodium hydroxide, and lime are the most common alkalis chemical implicated

 • Sulphuric, sulphurous, hydrofluoric, acetic, chromic and hydrochloric acid are the most common acids implicated

OPHTHALMIC EMERGENCY: immediate management is required!

 • Wash the eye(s) thoroughly with water until the pH returns to normal

 • Evert the eyelids to ensure chemicals are not retained

Obtaining a detailed history following initial management is essential:

 • Acidic injuries cause coagulative necrosis -> surface proteins form a protective barrier -> limited chemical penetration beyond the cornea

 • Alkali injuries cause disruptive liquefactive necrosis -> breakdown of normal cell barriers -> deeper chemical penetration

=> Pain, Redness, Watering, Decreased Vision, Foreign body sensation



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