Eye Irrigation

Aka: Eye Irrigation

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II. Indications

  1. Chemical Eye Injury

III. 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 additives
    1. Consider placing 10-15 cc of 1% Lidocaine in the saline bag to maintain adequate topical anesthesia during irrigation
  4. Irrigation device (any clean device that can direct irrigant flow to eye)
    1. Morgan Medi-Flow lens
    2. Intravenous tubing
    3. Nasal canula (attached to IV tubing)
      1. Can straddle the nasal bridge such that each nasal prong can be directed toward each eye

IV. 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

V. Precautions

  1. Never use acid or base to neutralize chemical burn

VI. Efficacy

  1. Eye Irrigation reduces risk of serious Eye Injury and dramatically reduces healing times
    1. Ikeda (2006) Ophthalmologica 220:225-8 [PubMed]

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Ontology: Irrigation of eye (C0022102)

Concepts Therapeutic or Preventive Procedure (T061)
ICD9 96.51
ICD10 92025-00
SnomedCT 49999004, 225684002
English Irrigation of eye, Irrigation of eye proper, irrigation of eye, irrigation of eye (treatment), cleaning eye, eye cleaning, Eye;washing, eye irrigation, cleaning eyes, Eye irrigation, Cleaning eye, Irrigating eye, Washing out eye, Cleaning eye (procedure), Irrigation of eye proper (procedure), Irrigation of ocular surface, Irrigation of eye, NOS, Irrigation of eye (procedure), eye washing
Italian Irrigazione oculare
Japanese 眼洗浄, ｶﾞﾝｾﾝｼﾞｮｳ
Czech Irigace oka
Hungarian Szem irrigatio
Spanish irrigación del ojo (procedimiento), irrigación del ojo, limpieza ocular (procedimiento), limpieza ocular, Irrigación ocular
Portuguese Irrigação ocular
Dutch oogirrigatie
French Irrigation de l'oeil
German Augenspuelung
Derived from the NIH UMLS (Unified Medical Language System)

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