Case challenge · Ophthalmology / Emergency · teaching

Chemical Eye Burn Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

← View the full flowchartBased on AAO / Roper-Hall

Case #1Ophthalmology / Emergency

📋 Case data

Irrigate immediately; grade the injurySevere (corneal opacity/limbal ischemia/painless white eye, Roper-Hall III–IV)

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · Irrigate immediately; grade the injury

Immediate copious irrigation to a neutral pH (priority, do not delay); after irrigation, corneal opacity/limbal ischemia?

💡 A true ophthalmic emergency. Alkali is worse than acid (alkali → liquefactive necrosis, saponification, deep penetration, irreversible at pH >11.5; acid → protein coagulation forming a barrier, shallower). Severe pain/photophobia/blurred vision/foreign-body sensation; a painless white eye = limbal ischemia (severe, not a reassuring sign); Roper-Hall grades by corneal opacity + limbal ischemia. Immediate copious irrigation is the most important first aid, do not delay for anything (water/saline/lactated Ringer, continue until the conjunctival sac pH is neutral 7.0–7.4, may need large volumes, longer for alkali); do not neutralize acid and alkali against each other.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.