Irrigation of the eyes

Laux. U. The water pic instrument for immediate intensive irrigation of the eye at the place of accident. Zentralbl Arbeitsmed. Arbeilsschulz Prophyl 26(10), 215-220 (1976). German... 

Laux, U., Roth, H.W. Intensive irrigation of the eye in hme bums by means of pulsating water stream (author s transl). Khn Monatsbl Augenheilkd 165(4), 664-669 (1974). German... 

When a poison has been inhaled, the first priority is to remove the patient from the source of exposure. Similarly, if the skin has had contact with a poison, it should be washed thoroughly with water. Contaminated clothing should be removed. Initial treatment of all types of chemical injuries to the eye must be rapid thorough irrigation of the eye with water for 15 minutes should be performed immediately. 

Symptomatic measures for the treatment of exposure to trichothecene mycotoxins are modeled after the care of casualties of mustard poisoning.85 Irrigation of the eyes with large volumes of isotonic saline may assist in the mechanical removal of trichothecene mycotoxins, but would have limited useful therapeutic effects. After the skin has been decontaminated, some erythema may appear, accompanied by burning and itching. Most casualties whose skin has been treated with soap and water within 12 hours of exposure will have mild dermal effects these should be relieved by calamine and other lotion or cream, such as 0.25% camphor and methanol. 

Intraocular irrigating solutions are required to be preservative-free to prevent toxicity to the internal tissues of the eye, particularly the corneal endothelium, lens, and retina [298,299]. These products are intended for single use only to prevent intraocular infections,... 

In the eye, hypertonic solutions may cause drawing of water towards the site of application whereas hypotonic solutions may cause water to move from the topical application site through the tissues of the eye. When instilled into the eye, isotonic solutions cause no contraction or swelling of the tissues with which they come in contact, and cause no discomfort. Therefore, it is very important to adjust the isotonicity of topical ophthalmic products. Isotonic adjustments are also important for nasal and aural preparations, parenteral products, and irrigating solutions. In a given product, all the... 

In the event of contamination of the eyes, common treatment includes irrigation with copious amounts of tepid water or physiological saline for at least 15 minutes and, in the event of persistent irritation, pain, swelling, or photophobia, expert ophthalmologic consultation. In the event of acute poisoning, transport... 

Generally replaced by the aminoglycosides or extended-spectrum penicillins for serious infections still used for bladder irrigation and gut decontamination used in combination wit hot her antibiotics and/or corticosteroids topically to treat infections of the eye and skin... 

Caution. Anhydrous hydrazines and solutions containing hydrazines are corrosive and can cause burns. They are also suspected to be carcinogens. Therefore, protective clothing must be worn, and the reactions should be performed in a well-ventilated hood. Affected areas of the eyes or skin should be irrigated with large volumes of water. If swallowed, the mouth should be washed out with copious amounts of water, and water to drink should also be administered. 

Chlorine. Lacrimation. Rhinorrhea. Conjunctival irritation. Cough. Sore throat. Hoarseness Laryngeal edema. Dyspnea. Stridor. ARDS. Pulmonary edema Decontamination Copious water irrigation of the skin, eyes, and mucosal membranes to prevent continued irritation and injury Symptomatic care (no antidote) Warm/moist air, supplemental oxygen, positive pressure O2 for pulmonary edema Bronchospasm Beta-agonists (albuterol) Severe bronchospasm Corticosteroids (prednisone) (also used for PTS with H/0 asthma but use unproven) Analgesia and cough Nebulized lidocaine (4% topical solution) or nebulized sodium bicarbonate (use unproven)... 

Because rose bengal also stains skin, clothing, and contact lenses, contact with these entities should be avoided. Wearers of soft contact lenses should perform a thorough irrigation of the ocular surfece and fornices before resinning contact lens wear. Irrigation after dry eye evaluation may be helpful to some patients. 

It has been also observed that hypertonic and hypotonic salt solutions tend to irritate sensitive tissue and cause pain when applied to mucous membranes of the eye, ear, and nose, etc., whereas isotonic solution causes no tissue irritation when it comes in contact with the tissue. Obviously, the tonicity of formulations that come in to direct contact with blood, muscle, eye, nose, and delicate tissues is critical. Therefore, the issue of tonicity is important in small- and large-volume injectables, ophthalmic products, and products intended for tissue irrigation. The degree of tissue irritation or hemolysis or crenation observed depends on the degree of deviation from isotonicity, the volume injected, the speed of injection, the concentration of the solutes in the injection, and the nature of the membrane. The parenteral and ophthalmic formulations are therefore adjusted to isotonicity if possible. 

Chlorhexidine has also been accidentally irrigated into the anterior chamber of the eye, instead of balanced salt solution, during cataract surgery (22). Later in the operation, a decrease in corneal clarity was noted and an epithelial abrasion had to be performed. The inadvertent use of chlorhexidine in this patient resulted in reduced endothelial function and loss of comeal clarity. 

Irrigation of the external eye is necessary in chemical injury or for removal of blood or mucus debris from the conjimctival fomices. BSS or any isotonic solution is suitable in an emergency, tap water can be used where no alternative is available. 

Chymotrypsin, USP. Chymotrypsin (Chymor) is extracted from mammalian pancreas and is used in cataract surgery. A dilute. solution is used to irrigate the posterior chamber of the eye to dissolve the fine filamcnLs that hold the lens. 

Exposure of the eyes to liquid chlorofluorocarbons or significant air concentrations should be treated by irrigating the eyes with tepid water for at least 15 min. Cryogenic dermal injuries should be treated by water bath rewarming until vasodilatory flush has returned. 

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