The effect of chemical injuries on childrens eyes and methods of protection

Chemical eye injuries are among the most serious accidents a child can experience. Even a small drop of a chemical—whether a cleaning agent or sanitizer—can cause severe damage to the cornea and lead to vision impairment if not treated promptly. Many parents don’t realize that rapid intervention is what determines the outcome for the child’s eye—whether it will fully recover or be permanently affected. In this Dalili Medical article, we’ll explain the causes of these injuries, their key symptoms, and how to respond correctly to protect your child’s vision.

1️⃣ Are chemical eye injuries serious?

Yes, these injuries can rapidly damage the cornea and may lead to permanent vision loss if not treated immediately. Quick action is what determines whether the eye fully recovers or suffers long-term complications.

2️⃣ What should I do if a chemical gets into my child’s eye?

Rinse the eye immediately with plenty of running lukewarm water for 10–20 minutes without rubbing or using any other substances. After that, go to a doctor immediately.

3️⃣ Can I use milk or saline instead of water?

No, water is the safest and most effective option. Other liquids may cause a chemical reaction and worsen the damage.

4️⃣ Do all chemical injuries cause permanent vision loss?

Not always. Minor injuries can heal completely if treated quickly and correctly. Delays or exposure to strong chemicals may result in corneal opacity or permanent vision impairment.

5️⃣ When should I go to the emergency room immediately?

Seek emergency care if you notice any of the following:

Severe pain that doesn’t improve after rinsing.
White spots or color changes on the cornea.
Blurred or reduced vision.
Child cannot open the eye at all.

6️⃣ Do I still need to see a doctor if my child seems fine after rinsing?

Yes. Even if the eye looks normal, internal tissue damage may not be visible externally. Only an ophthalmologist can properly assess the eye.

7️⃣ How can I protect my child from chemical eye injuries?

Prevention is always better than treatment. Key steps:

Keep all cleaning products and chemicals out of reach.
Don’t leave open bottles of perfume or sprays accessible.
Teach your child not to touch unknown substances.
Use protective goggles for any activity involving chemicals.

8️⃣ Will my child need surgery?

In severe cases where the cornea or internal eye structures are deeply damaged, a doctor may recommend surgery such as a corneal transplant or conjunctival repair to preserve or improve vision.

Stages of Chemical Eye Injuries in Children

The severity and depth of the chemical exposure determine the injury stage, and faster treatment reduces complications.

1️⃣ Early Stage (first minutes to hours)

Occurs immediately after contact.

Symptoms:

Severe burning pain and excessive tearing
Redness and swelling of the eyelids
Difficulty opening the eye and strong light sensitivity

What happens:
The chemical begins reacting with the eye surface (cornea and conjunctiva), causing tissue damage or erosion depending on its strength.

2️⃣ Acute Stage (first 7 days)

Complications become more apparent.

Symptoms:

Persistent pain and redness
White spots or corneal opacity
Blurred or reduced vision

What happens:
Deeper tissues may be affected. The eye attempts to “repair itself” through inflammation. Without prompt treatment, corneal ulcers may form.

3️⃣ Sub-Acute Stage (1–3 weeks)

The body begins healing.

Symptoms:

Slight improvement in pain and redness
Continued blurriness or opacity
Possible adhesions in the conjunctiva or minor eyelid deformities

What happens:
Wound healing begins, but deep damage may leave scars. Abnormal blood vessel growth may occur in the cornea.

4️⃣ Chronic / Late Stage (after 3 weeks – months)

The most dangerous stage for severe injuries.

Symptoms:

Partial or permanent vision loss
Chronic dryness or light sensitivity
Corneal or conjunctival deformities

What happens:
Damaged tissues may not return to normal. Some cases require surgery to restore vision or correct deformities.

Causes of Chemical Eye Injuries in Children

Chemical injuries are among the most dangerous accidents for children because they can rapidly damage eye tissue if untreated. Common causes include:

1️⃣ Household cleaning products

Chlorine, strong detergents, glass/floor cleaners, laundry bleaches
Children may touch them and rub their eyes or spray accidentally during play

2️⃣ Cosmetics and perfumes

Children may imitate adults and accidentally spray perfume or deodorant into their eyes, causing irritation or burns

3️⃣ Chemicals at school or laboratories

Exposure during science classes or experiments without supervision or proper safety equipment

4️⃣ Battery leakage

Battery fluids, especially from car batteries or large toys, are highly caustic and can rapidly damage the cornea

5️⃣ Pesticides and fertilizers

Spraying or touching these substances can severely damage eye tissue

6️⃣ Home experiments

Simple home science experiments without protective goggles may lead to direct contact with corrosive chemicals

Symptoms of Chemical Eye Injuries in Children

Symptoms appear quickly after chemical contact. Any of the following requires immediate ophthalmologic evaluation:

Severe redness
Intense pain or burning
Excessive tearing
Eyelid or eye swelling
Difficulty opening the eye
Blurred or reduced vision
White spots or corneal color changes (advanced damage)

Types of Chemical Eye Injuries in Children

Injuries are classified according to the chemical type and strength, helping the doctor determine appropriate treatment:

☣️ Alkaline Injuries (Most Dangerous)

Examples: Chlorine, ammonia, oven or drain cleaners.
Why dangerous: Alkaline substances penetrate eye tissues quickly, causing severe destruction.
Symptoms: Severe pain, redness, rapid vision loss, white spots on the cornea.

2️⃣ Acid Injuries (From Acidic Substances)

Examples: Battery acid, some toilet cleaners, rust removers.

Less dangerous than alkalis but still serious because they burn the eye surface and may cause corneal ulcers.
Symptoms: Burning pain, tearing, redness, swelling, and possible opacity.

3️⃣ Irritant Injuries (Non-Corrosive Substances)

Examples: Soap, shampoo, perfumes, some cosmetics.

Usually cause only superficial irritation and improve after thorough washing.
Symptoms: Mild burning, tearing, slight redness.

4️⃣ ⚠️ Mixed or Unknown Injuries

Sometimes the type of chemical is unknown, especially in young children.
In these cases, the doctor treats it as a severe injury until the exact cause is identified.

Diagnosing Chemical Eye Injuries in Children

Rapid diagnosis is essential because every minute counts in preserving the child’s vision. The ophthalmologist follows precise steps to assess the injury and start treatment:

1️⃣ Taking a Quick Medical History

Determine the type of chemical (alkali, acid, cleaner, etc.).
Note the time of exposure and whether the eye was rinsed.
This information helps the doctor gauge the severity and progression of the injury.

2️⃣ External Examination of the Eye and Eyelids

Look for redness or swelling.
Identify surface damage such as ulcers or white spots.
Check for chemical residue on the skin or eyelashes.

3️⃣ Measuring Eye pH

A crucial step to assess damage.
Special pH strips are used; the eye’s pH must return to normal (7–7.4) before a full exam.
If pH is still abnormal, continue rinsing with water or saline.

4️⃣ Cornea and Conjunctiva Examination with Slit Lamp

A special device provides a detailed view of the eye.
Detects corneal erosion or damage, abnormal blood vessel growth, adhesions, and early complications.

5️⃣ Visual Acuity Test

Helps determine how much the vision is affected.
Guides the doctor in planning treatment.

6️⃣ Additional Tests for Severe Cases

Fluorescein staining to locate ulcers or scratches.
Posterior eye exam if deeper structures are suspected to be damaged.

Treatment of Chemical Eye Injuries in Children with Medications

Once the eye has been thoroughly rinsed and pH normalized, the doctor begins medication treatment based on injury severity and depth:

Antibiotic drops
- Prevent secondary infection.
- Used multiple times daily as prescribed.
Artificial tears (moisturizing drops)
- Keep the eye hydrated and reduce irritation and dryness.
- Used multiple times daily to aid healing.
Corticosteroid drops or ointments (under supervision)
- Reduce inflammation and swelling.
- Must be used carefully; improper use can delay healing.
Mydriatic drops (pupil-dilating/antispasmodic)
- Reduce pain caused by eye muscle spasms and prevent internal adhesions.
- Prescribed if the injury reaches the inside of the eye or affects the iris.
Pain relievers
- Relieve pain and burning, especially in the first days.
- Can be in drops or oral tablets depending on the case.
Anti-scarring or healing-support medications (severe cases)
- Reduce scar formation and improve corneal healing.
- Often used in the hospital under close supervision.

Important Notes:

Do not self-administer medications; treatment depends on chemical type and injury severity.
Continuous follow-up with the ophthalmologist is necessary as the condition can change rapidly.
In very severe cases, surgery may be needed later.

Surgical Treatment for Chemical Eye Injuries in Children

Surgery is a last resort, performed only in very severe cases or when permanent damage cannot be treated with medications. Main surgical interventions include:

Debridement (removal of damaged tissue)
- Removes injured cells to prevent infection and promote new healing.
Corneal transplant / graft
- Restores vision and improves corneal transparency in cases of complete damage or opacity.
Amniotic membrane transplant
- Covers the damaged eye to reduce inflammation and speed healing.
- Often used before corneal transplantation in moderate to severe cases.
Adhesion release or conjunctival repair
- Restores normal eye movement and prevents surface deformities.
Dacryocyst or eyelid surgeries
- Improve eye function and protect against dryness and infections if tear ducts or eyelids are damaged.

Important Notes:

Not all cases require surgery; the ophthalmologist decides after careful examination.
Some eyes may need multiple staged procedures.
Post-surgery follow-up is essential to prevent complications and achieve the best vision outcome.

First Aid for Chemical Eye Injuries in Children

Immediate action is critical to prevent permanent vision damage. Follow these steps:

1️⃣ Stay calm and act quickly

Every second counts! Stay composed to avoid increasing the child’s anxiety.

2️⃣ Rinse the eye immediately with running water

Use lukewarm or normal water (not hot or cold).
Let the water flow from the inner corner (near the nose) outward to avoid contaminating the other eye.
Continue rinsing for 10–20 minutes even if the child cries or cannot open the eye.

Tips during rinsing:

Never rub the eye.
Do not use any drops or solutions other than water unless instructed by a doctor.
Remove contact lenses if present.

3️⃣ Remove any remaining chemical

Gently wipe residue from skin or eyelashes with a damp cloth without pressing on the eye.

4️⃣ Go to a doctor immediately

Even if the eye looks better after rinsing, a visit to an ophthalmologist or emergency department is necessary to rule out deep damage.

Never do:
❌ Attempt to neutralize the chemical with another substance.
❌ Use milk or household liquids instead of water.
❌ Rub or press on the eye.

Prevention of Chemical Eye Injuries in Children

Prevention is easier and safer than treatment. Most accidents happen at home due to curiosity or neglect. Key steps:

1️⃣ Keep chemicals out of reach

Store cleaners, chlorine, pesticides, batteries, and other dangerous substances in locked, elevated locations.
Never store chemicals in water or juice bottles that could be mistaken for drinks.

2️⃣ Childproof the home