Now You See Me, Now You Don’t

​A 32-year-old man presented to the emergency department complaining of eye pain and decreased vision. He worked for the city and was removing rust and graffiti from a wall with a power washer when the spray ricocheted off the surface and into his eye. He presented with a bottle of the chemical he used, which contained hydrofluoric acid (HF) and other chemicals. He rinsed his eyes with tap water, but experienced persistent decreased vision and pain in both eyes. His exam was remarkable for bilateral injected conjunctiva and excessive tearing.More than 7,000 ocular exposures were reported to U.S. poison control centers per month from 2000 to 2016. (Ophthalmic Epidemiol 2018:1. doi: 10.1080/09286586.2018.1521982.) The highest rate of exposures was among children younger than 6 years old and lowest among adult patients 20 or older. The majority of these exposures were mild, with less than one percent needing hospital admission, but these injuries may cause significant and permanent damage to the patient. Most exposures were from household cleaning products (22%), followed by cosmetics, personal care products, and pesticides. These patients generally present with severe pain and complaints of vision changes or loss.Routes of Ocular ExposureDirect ocular injury from a liquid chemical such as household cleaning products being splashed into the eyeExposure to chemical vapors, i.e., chlorine gas exposureExposure to topical ophthalmic medications such as accidental overdose ...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs