We saw our first Tide Pod chemical eye burn on Saturday. Her ph was 8 when she walked in. She was in a lot of pain and had a large corneal abrasion.
The key thing when examining these patients is to get them irrigated as soon as possible and get the pH down to a 7.
Here is our Chemical Burn Protocol:
1. Front desk needs to tell these patients to come in asap: the pt this am says Tide Pod splashed in her eye last night. 911 needs to be called when a chemical hits the eye if one cannot get into the eyeMD’s asap. Tell patient if calls to start irrigating with water asap at least for 20 minutes as waits for 911.
2. Check pH with pH Strip asap
3. Try to take photos if needed & quick look at slit lamp after 1 drop of Fluorescein before & after irrigation
4. Start irrigation otherwise ASAP until pH is 6.5- 7.5.
5. Check pH every 15-20min right before & then during BSS irrigation until pH is about a 7pm
6. Send home on
a) antibiotic: to prevent superinfection
b) steroid 2-4x/day: to decrease inflammation. May need to wait till corneal epithelium is healed before starting in some patients.
c) doxycycline 20mg po qd
d) autologous serum 4x/day if available
d) f/u 1-2days depending on severity