Symptoms and Signs of Chemical Eye Burns

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 8/30/2021

Doctor's Notes on Chemical Eye Burns

Chemical exposure to any part of the eye or eyelid may result in a chemical eye burn. Permanent damage from a chemical eye burn is possible and blindness can occur. The severity of an eye burn depends on what substance caused it, how long the substance was in contact with the eye, and how the injury is treated. Damage from a chemical burn to the eye is usually limited to the front segment of the eye, including the cornea, the conjunctiva, and occasionally the internal eye structures of the eye, including the lens. Burns that penetrate deeper than the cornea are severe and can cause cataracts and glaucoma.

Symptoms of chemical eye burns include

  • eye pain,
  • redness,
  • irritation,
  • tearing,
  • inability to keep the eye open,
  • feeling as if something is in the eye,
  • eyelid swelling, or
  • blurred vision.

Serious chemical eye burn symptoms include glaucoma (an increase of the pressure inside the eye) and loss of vision.

What is the Treatment for Chemical Eye Burns?

Chemical burn injuries to the eye should be referred to an ophthalmologist (a doctor who specializes in diseases and condition of the eyes) for consultation, treatment and follow up. 

For most chemical eye burns, the goal of treatment is to encourage healing and reduce pain while decreasing inflammation and preventing secondary infection. 

Treatment is based on the grade of injury as follows:

Grade I

  • For grade I injuries, a mild topical antibiotic ointment such as bacitracin or erythromycin typically is prescribed, along with preservative-free artificial tears as needed. 
  • A topical steroid such as prednisolone acetate, is usually sufficient to control inflammation and facilitate surface healing.

Grades II to IV

  • For more severe burns, the control of inflammation in the acute phase, particularly the first week after injury, is of utmost importance. 
  • Topical prednisolone acetate 1 percent is recommended. A long-acting cycloplegic such as scopolamine hydrochloride or atropine sulfate, along with oral pain medications should be used. 
  • To prevent superinfection in cases with complete eye surface loss, a topical broad-spectrum antibiotic (such as a fluoroquinolone) may be given along with an oral tetracycline such as doxycycline
  • Additionally, oral administration of high-dose vitamin C may prevent or delay ulceration.

Some cornea specialists advocate early placement of amniotic membrane (such as Prokera) on the ocular surface in grade II, III, or IV burns, and the risks of doing so are low.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.