Eye Irrigation Procedure

Importance

• Immediate irrigation is crucial following a chemical injury.
• Be swift while ensuring no errors, and maintain respect for the patient.

Preparation Steps

• Hands and PPE: Wash hands and don personal protective equipment (PPE).
• Equipment Needed:
  • Local anaesthetic drops
  • PH paper
  • Speculum
  • Towel
  • Bowl
  • Cotton buds
  • Jug
  • Syringe
  • Giving set
  • Clean irrigating fluid

Procedure

1. Explain and Consent:
   • Clearly explain the procedure to the patient.
   • Obtain the patient's consent.
2. Positioning:
   • Lie the patient down.
   • Have the patient lean back on a seat and tilt their head towards the affected eye.
   • Place a towel and bowl to catch excess fluid.
3. Anaesthesia and Preparation:
   • Apply local anaesthetic drops to the eye.
   • Remove any contact lenses.
   • Use fingers to open the eye gently.
4. Irrigation:
   • Pour fluid from a close distance using a jug or giving set.
   • Alternatively, use a speculum and a large syringe to irrigate.
   • Instruct the patient to look in different directions.
   • Ensure the lower fornix is irrigated and evert the upper lid to remove foreign bodies.
   • Use cotton buds to remove persistent foreign bodies if necessary.
5. Duration:
   • Continue irrigation for at least 15 to 30 minutes.
   • Use litmus paper to check for neutral pH, if available.

Post-Irrigation Examination

• Examine the eye thoroughly:
  • Use the anterior segment loop of the arclight.
  • Check for signs of serious injury such as:
    • Blanched blood vessels
    • Hazy cornea
    • Corneal epithelial loss (use fluorescein and blue light of arclight)

Referral

• If serious injury signs are present, refer the patient to an eye specialist.