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Author: Frank R. Burns, MD and Christopher A. Paterson, PhD, DSc.
Publication: Occupational Health & Safety (April 1989)
Chemical burns to the eye are among the most urgent of ocular emergencies. The clinical outcome of the injury is directly related to the expediency with which treatment is begun. Copious irrigation is the most important emergency treatment of the chemically burned eye. This irrigation should begin immediately at the scene of the accident with any nontoxic liquid. Removal of any particulate matter must be done to prevent further ocular damage. The subsequent therapy is directed at the treatment of secondary sequelae and at preserving the globe to surgically rehabilitate the eye. Many of the treatments, which are used in the intermediate and late phases of the injury, are used to prevent corneal ulceration and perforation. These are the most difficult sequelae to threat in alkali injuries; thus, preventing the progression to this stage is of the utmost importance. Again the immediate and continuous irrigation of the eye may help accomplish this goal.
The availability of emergency eyewash equipment dispensing a safe, preserved, pH-balanced, physiologically correct solution in the industrial, agricultural and even the home setting is a necessity. The education of employees and family members in the proper technique of irrigating the eye following a chemical burn is also of extreme importance. Immediate irrigation of the eye, continued during rapid transport to a medical care facility, minimizes the damage to the eye and enhances the eventual clinical outcome.
While beginning to wear contact lenses, I had an experience which the use of the Morgan Lens saved the day.
I was just finishing a sixteen-hour shift as manager and staff nurse of the ED when I was notified that they had received a bomb threat. Disaster situation were part of my duties, so I went into action. By 4:00 AM, I realized I still had my contacts in. So I got a container and soaked them in an eye solution from our eye tray. I arrived home with enough time to take a quick nap before returning to work for another sixteen-hour shift. When I put my contacts in, I felt like someone had placed a hot poker into my eyes. I took the contacts out, but my eyes continued to burn and were also fire engine red. I did report to work at 7:00 AM but my eyes continued to burn. I then decided the best thing I could do was to irrigate, so I placed a Morgan lens into both eyes and irrigated with 1000 cc of lactated Ringer's. Laying down during the irrigation process was relaxing and I felt no discomfort while my eyes were irrigated. After the process, the burning was relieved and I was able to complete my shift without further discomfort.Registered Nurse (South Carolina)
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.