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Eye Irrigation

Indications
1. Chemical Eye Injury
Equipment
1. pH paper
2. Eye irrigation fluid (Use best option that is immediately available)
  1. Preferred irrigants (liter bags - may require up to 10 liters)
    1. Normal saline or
    2. Lactated ringers
  2. Alternatives if preferred agents unavailable
    1. Sterile water
    2. Eyewash station or equivalent clean water supply
3. Irrigation device (any clean device that can direct irrigant flow to eye)
  1. Intravenous tubing
  2. Nasal canula
  3. Morgan Medi-Flow lens
Technique
1. Pre-treat with Topical Eye Anesthetic (if available)
2. Do not delay irrigation for contact removal
  1. Contacts can be removed after irrigation
3. Immediate copious irrigation for at least 30 minutes
  1. After 30 minutes of irrigation, close eye for 5 minutes
  2. Test Eye pH (goal is neutral pH 7.0 to 7.3)
    1. Continue eye irrigation until Eye pH 7.0 to 7.3 (may require up to 10 liters of irrigant)
    2. If pH paper not available, irrigate for minimum of 2 liters irrigant over 30 minutes
4. Adjunctive measures
  1. Consider sweeping medial and lateral canthus for crystallized chemical
    1. Use moist swab to remove debris from Conjunctival fornices
    2. May be speed neutralization of pH
Precautions
1. Never use acid or base to neutralize chemical burn
Efficacy
1. Eye irrigation reduces risk of serious Eye Injury and dramatically reduces healing times
  1. Ikeda (2006) Ophthalmologica 220:225

Irrigation of eye (C0022102)
Concepts	Therapeutic or Preventive Procedure (T061)
ICD9	96.51
English	Cleaning eye, Irrigating eye, Irrigation of eye, Irrigation of eye proper, Irrigation of ocular surface, Washing out eye
Spanish	irrigacion del ojo, limpieza ocular
Parent Concepts	Other nonoperative irrigation and cleaning (C0178117), Irrigation (C0022100), Procedure on eye (C0196950), Procedure on anterior segment of eye (C1293039)
Sources	ICD9CM, MTH, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System)