Chemical burns can be complicated injuries that require extensive treatment. At Burn and Reconstructive Centers of America (BRCA), our multidisciplinary approach to burn injuries promotes the best possible outcomes for all patients treated at our nationwide care centers. While BRCA encourages patients to seek medical attention when an injury occurs, we do our best to educate online and in-person communities on the risks, treatments and preventions of various burns, wounds and skin and soft tissue disorders for the benefit of better care and recovery.
What is a chemical eye burn?
A chemical eye burn occurs when the eye or eyelid is exposed to a corrosive chemical agent, such as a acid or alkaline. Chemical burns account for 5% of all burn injuries but according to WebMD, only about 7-10% of those chemical injuries involve the eye. However, when chemical eye burns occur, they are considered ophthalmological emergencies.
Common causes of chemical eye burns
Exposure to toxic chemicals can happen anywhere, from the fluids in our cars to the cleaning products in our homes. Potentially dangerous substances are a part of our everyday lives. Acidic and alkaline substances, such as bleach and paint thinner, are some of the most common caustic agents to cause irritation or severe injury.
Alkaline burns: On an average pH (power of hydrogen) scale numbered from zero to 14, an acid is what measures from zero to six, and an alkaline substance measures from eight to 14, with seven being neutral. The stronger the base, the higher the number—meaning 14 is the category of the strongest alkaline substances. Alkaline substances are made of soluble hydroxides, including lithium, potassium and sodium, and some of the most common alkaline chemical burn agents are sodium hydroxide, potassium hydroxide and calcium hydroxide. These agents can be found in industrial and household cleaning products, cement, fertilizers, hair dye, hair relaxers and more.
Acid burns: The stronger the acid is, the lower the number—meaning one is the category of the most potent acids. Some of the most common acid burn agents are hydrochloric acid, sulfuric acid, formic acid, hydrofluoric acid and chromic acids. These agents can be found in laboratories, cleaning products, factories and industrial plants, batteries, etc.
Outside of acid and alkaline burns, plenty of products can cause mild to moderate irritation, including some chemical skin peels, beauty products, insecticides, pepper spray, detergents and soaps. These products may cause itchiness, swelling, rash, hives or conjunctivitis.
Chemical eye burn symptoms
Though your eyes have their own cleaning system, they are a sensitive part of the body that can get injured easily and suffer lifetime complications. Therefore, chemical eye burns are considered ophthalmological emergencies, and medical treatment should be sought immediately. If your eye or the surrounding area is exposed to possible chemical irritants, be aware of the following immediate or delayed signs and symptoms of a possible chemical burn injury:
- Irritation (itchiness, burning, feeling of something in your eye)
- Redness of the eye or surrounding parts of the eye
- Blurred, double vision or cloudy vision
- Inability to open or close the eye
Factors that may affect the severity
Like radiation burns, chemical burns may not present immediately. There can be a delayed reaction, especially if the substance is not washed away and remains on your skin or eye for an extended period. Factors that may affect burn severity include:
- The type of chemical you were exposed to
- Whether the chemical was diluted or concentrated
- How long you were in contact with the chemical before it was neutralized
- Suffering from pre-existing skin or eye conditions that may increase sensitivity and the rapidity of the burning process
Chemical eye burns are classified similarly to all other burn types—in degrees.
First-degree chemical eye burns: Considered a minor eye injury but emergent nonetheless, this degree of chemical eye burn injury is characterized by a clear cornea with an absence of limbal ischemia or a white film over the eye. The prognosis for recovery is typically excellent unless complicated by pre-existing conditions or other problems.
Second-degree chemical eye burns: A moderate injury, second-degree chemical eye burn injuries are characterized by a cloudy cornea where the details of the iris are still visible. The outlook for this injury is typically good unless complications are encountered during treatment.
Third-degree chemical eye burns: A severe injury, third-degree chemical eye burn injuries are characterized by complete loss of the outer layer of tissue on the cornea and near-complete opacity of the iris where details are not readily visible. The prognosis of recovery can vary.
Fourth-degree chemical eye burns: The most severe chemical eye burn injury, this degree of burn is characterized by a completely opaque or obstructed cornea. Eye or sight recovery from this degree of damage is not likely.
If your eye or the surrounding area is exposed to a chemical agent, irrigate the affected area with water frequently and copiously. This means removing contact lenses and continuously rinsing the eye/s with water for at least ten minutes. Rinsing the eye continuously with running water will help dilute the chemical agent and remove any particles that may be trapped in there. In a work or school environment, an eye wash station is available for this purpose. However, it is recommended to use cold tap water via sink or shower at home if a sterile saline solution is unavailable. For optimal irrigation, keep your eye/s wide open while the water or saline solution cleanses the area. If you cannot keep your eye open, you may need to manually open the eyelids as this will help remove more debris and reach all eye areas.
BRCA only recommends at-home care for chemical eye burns when supplemented by a visit to a doctor or burn center. Chemical eye burns are a medical emergency; medical attention should be sought during or immediately after irrigation. Irrigating the eye with tap water or sterile saline is the only treatment advised for at-home care as it is an important step in minimizing the damage.
You should never attempt to neutralize chemicals at home, as this could lead to further chemical reactions and injury. If some of the product is ingested, please call poison control at 800-222-1222.
After rinsing the eye/s for an extended period, seek medical attention immediately to minimize the long-term effects of the chemical eye irritation or burn. At BRCA, our healthcare teams assess the eye and determine the degree of burn injury. From there, a thorough eye examination is performed where samples might be sent to the lab to determine what chemical agent is present if the patient doesn’t already know. During this examination, the eye’s structure, the eyelids’ reflex, the pH of the eye and patient sight are tested to help determine the extent of the injury. If the injury is minor, the healthcare team will neutralize the chemical and send the patient home with eye drops and medication to follow up another day. If the injuries are moderate, the healthcare team may keep the patient overnight for observation. However, more severe eye injuries such as third-degree or fourth-degree chemical burns may require surgical intervention or reconstruction.
Outlook for chemical eye burns
The outlook for chemical eye burns can vary depending on several factors, including some of the same factors that affect burn severity. Some known short-term effects of chemical eye burns include:
- Blurring, double or cloudy vision
Some long-term effects may include:
- Scarring on the eye that may or may not affect the functionality
- Development of glaucoma
- Formation of cataracts
- Sight reduction
- Temporary or permanent blindness
- Temporary or permanent dry eye/s
Some long-term effects can be managed; such as the formation of cataracts. However, most other effects are irreversible. If the skin, tissue or muscle surrounding the eye are damaged, reconstruction is an option that can help maintain or improve eye function.
Reconstruction may be necessary to improve eye function for patients with more severe eye injuries, especially those involving the eyelids or outlying structure. Some reconstructive procedures include:
- Eyelid reconstruction to help restore the ability to blink, protecting eye moisture
- The replacement of damaged limbal stem cells to prevent surface scarring
- A corneal transplant to replace a severely damaged cornea
- Laser surgery to help remove cataracts, manage glaucoma or improve overall vision
Chemical eye burn prevention
Chemical eye burns can happen to people of all ages in various ways. To help prevent this medical emergency, please consider the following safety tips:
- Never throw away hazardous chemicals in waste bins that are easily accessible to children
- Always wear eye protection when handling potentially hazardous materials
- Always wear hand protection when handling cleaning products, including bleach, drain cleaner, toilet bowl cleaner, etc.
- Always read the directions before using chemical agents
- Use the original containers. Never store chemicals in old food or drink containers or keep them in the same place as consumable products.
- If you’re handling chemicals at work, ensure you’ve had the proper health, safety and OSHA standards training.
Chemical eye burns are avoidable when we are aware of the hazards. Applying these basic chemical safety rules can reduce the chances of a chemical injury.
For more information about chemical burns, please visit our website at www.burncenters.com. If you are suffering from a battery acid burn, please don’t wait to seek help. Call our experts 24/7 at (855) 863-9595 for your non-emergent needs. For emergencies, please call 911 or, if a potentially hazardous substance has been swallowed, call the Poison Control Hotline at (800) 222-1222.
For more information on chemical burns, please click here.
For information on bleach burns, please click here.
For information on battery acid burns, please click here.
For information on chemical burns from hair dye, please click here.