What is the initial action in eye injury with chemical exposure?

• A. Begin ocular irrigation immediately.
• B. Assess mechanism of injury.
• C. Elevate head of bed 45 degrees.
• D. Do not give analgesia.

Answer: (A)

In chemical eye exposures, the priority is to rapidly remove the chemical and limit tissue damage by immediate irrigation. The chemical can continue to harm the eye as long as it remains in contact with the surface, so flushing with clean water or isotonic saline as soon as possible dilutes and washes it away, reducing caustic or irritant effects. Start irrigation right away, keeping the eyelids gently open and allowing a steady stream to flush the eye for an extended period (typically 15–30 minutes). If a contact lens is in place, remove it if it’s safe to do so during the irrigation.

After beginning irrigation, you can assess and monitor the situation—check the eye’s pH if available and continue rinsing until the pH is near neutral and there are no signs of ongoing chemical injury. Analgesia and other supportive measures can be considered after irrigation, but delaying flushing would risk greater damage. Other steps, like evaluating the mechanism of injury or elevating the head, are important parts of ongoing care but do not replace the need for immediate irrigation.