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Clinical Comparison of Ocular Irrigation Fluids Following Chemical Injury

Author: Herr RD, White GL Jr, Bernhisel K, Mamalis N, Swanson E

Journal: Am J Emerg Med 1991 May;9(3):228-31

Abstract: This study tested the hypothesis that four ocular irrigating solutions were equally irritating during copious irrigation. We conducted a prospective, double-blind study of patients with chemical exposure to the eye. Each underwent cross-over irrigation with all of the following in random order: normal saline (NS), lactated Ringer’s (LR), normal saline adjusted to pH 7.4 with sodium bicarbonate (NS + Bicarb), and Balanced Saline Solution Plus (BSS Plus, Alcon Laboratories, Fort Worth, TX). Compared with traditional NS and LR, NS + Bicarb tended to be more comfortable. BSS Plus was statistically superior (P less than .05) to NS and preferred over LR and NS + Bicarb. Three patients demanded discontinuance of NS or NS + Bicarb infusions. All solutions had comparable normalization of conjunctival pH and degree of injection. Alternate solutions including BSS Plus should be considered for use in those patients whose poor tolerance to normal saline threatens to delay or interrupt eye irrigation following a chemical injury.

MorTan Note: This study, done on patients with actual chemical burns, involved 11 patients and 12 eyes.

A 60-year-old female splashed cleaning solution in her eyes.  She was irrigated with the Morgan Lens until pH returned to normal.  Afterwards, she told me, "You know, contact lenses are a lot more comfortable than I thought. Maybe I should get some!".  Her chemical conjunctivitis resolved nicely without sequelae. A clinical success.

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Why Use The Morgan Lens?

The Morgan Lens is used in 90% of hospital emergency departments in the USA and can be inserted in less than 20 seconds. There simply is no other "hands-free" method of eye irrigation. Nothing else frees medical personnel to treat other injuries or to transport the patient while irrigation is underway. Nothing is more effective at treating ocular chemical, thermal, and actinic burns or removing non-embedded foreign bodies, even when the patient's eyes are closed tightly. Its design makes it simple and straightforward to use so minimal training is required.