Chemicals in the eye (eye burn)

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Chemicals in the eye (eye burns)
An eye burn is caused by contact with acidic or alkaline substances, cleaners or solvents. Alkalies in particular penetrate deep into the tissue and can severely damage the cornea and conjunctiva. Any chemical exposure to the eye is an emergency because of the threat of blindness.

An eye burn is a serious injury in which chemical substances come into contact with and damage the sensitive tissues of the eye. The eye of dogs and cats consists of various highly sensitive structures that can be quickly and permanently damaged when exposed to corrosive substances. The cornea, the conjunctiva, and the sclera are particularly at risk because they form the outer protective layers of the eye and are therefore the first to come into contact with chemicals.

The severity of a burn is largely determined by three factors: the type of chemical, its concentration, and the duration of exposure. Alkalis (alkaline substances) are particularly problematic because they penetrate deeper into the tissue than acids and thus often cause more severe damage. While acids cause coagulation necrosis on the surface, which limits further penetration, alkalis lead to colliquation necrosis, which allows deeper penetration and can therefore have more serious long-term consequences.

Causes

Eye burns in pets are caused by contact with various chemical substances found in the household, garden, or garage. The most common causes can be divided into the following categories:

Alkaline substances (lyes) are the most dangerous group. These include cleaning agents such as drain cleaner, oven and grill cleaner, detergents, ammonia compounds, and construction chemicals such as cement, lime, and concrete. These substances have a pH value above 7 and can penetrate particularly deeply into the eye tissue because they liquefy proteins and fats.

Acidic substances with a pH value below 7 include battery acid, rust remover, swimming pool chemicals, toilet cleaner, and certain fruit vinegars in high concentration. Although acids tend to cause more superficial damage than alkalis, they can still cause significant injury.

Organic solvents such as gasoline, turpentine, nail polish remover, and antifreeze remove fats from the tissue and can thereby destroy the lipid layer of the cornea. This leads to increased permeability for other pollutants.

In dogs and cats, there are additional breed-specific risks. Brachycephalic (short-headed) breeds such as pugs, French bulldogs, or Persian cats have anatomically protruding eyes that are less protected by the orbital cavity and are therefore exposed to a higher risk of injury. In addition, behavioral factors such as sniffing in waste containers or exploring garages and workshops can increase the risk of eye burns.

Symptoms

Chemicals in the eye/eye burn in dogs and cats

Typical Symptoms:

  • Severe blinking, squinting, rubbing, pain
  • Tearing, redness, swelling
  • Cornea dull/cloudy, light sensitivity

Alarm signs:

  • Visible corneal opacity/whitish areas, “milky” eye
  • Bulbus change, severe blepharospasms, no opening possible
  • Chemical was strongly alkaline/caustic (e.g. cleaner)
  • Suspected vision loss, pupil anomalies

Escalation/course:

  • Damage deepens in the first hours → immediate flushing critical
  • 6–24 h: increasing cloudiness/ulceration possible → escalation
  • Days later: necrosis/perforation possible with severe burns

 

Description of Symptoms: Severe pain, impaired vision up to vision loss, increased blood flow to the conjunctiva or a pale conjunctiva if the vessels are destroyed and thereby reduced blood flow to the region, edema of the eyelids and/or conjunctiva, spasmodic eyelid closure (blepharospasm), corneal opacity (fish eye):

The symptoms of an eye burn in dogs and cats usually occur immediately after contact with the damaging substance and can vary depending on the severity and type of chemical. The characteristic signs include:

Acute expressions of pain are often the first recognizable symptom. Affected animals show restlessness, yelping or whining and try to rub their eyes with their paws. Spasmodic eyelid closure (blepharospasm) occurs as a protective reaction and can be so severe that the animal can hardly open its eye.

The conjunctiva reacts with strong redness (hyperemia) due to increased blood flow. In very severe burns, however, a pale conjunctiva can also occur if the blood vessels have already been destroyed. Increased tear production (epiphora) is another attempt by the body to flush out the damaging substance.

Various changes can be observed on the cornea. Corneal opacity (also known as “fish eye”) is caused by damage to the normally transparent corneal tissue. In severe burns, corneal erosions or even ulceration (deeper defects) can occur. In advanced cases, perforation of the cornea can occur.

The eyelids and conjunctiva can swell severely (edema), and in severe cases, tissue necrosis can occur. Impairment of vision up to complete vision loss is possible, with the animal showing signs such as unsteady gait or bumping into objects.

Special considerations for cats

In cats and dogs, the symptoms may differ slightly. Cats tend to withdraw and hide their discomfort when they have eye pain, while dogs are more likely to show obvious pain reactions. Therefore, special attention should be paid to cats in order to recognize eye burns early.

First Aid

  1. If chemicals get into the eyes, flush the affected eye as quickly as possible, for a very long time (at least 15 minutes), under running, lukewarm or cold water. If necessary, non-alcoholic beverages can also be used.
  2. Exception: Do not rinse if lime has gotten into the eye. This must be removed mechanically. Rinsing with water would create a highly corrosive alkali, which in turn would cause severe damage.
  3. Try to open the eyelids. If your pet is not cooperative, try to flush anyway, even if you have to compromise on thoroughness.
  4. Try to flush near the eye so that the water at least runs over the eyes.
  5. Turn the animal’s head so that the affected eye is lower, so that no rinsing liquid can flow into the healthy eye.
  6. However, do not rub.
  7. Do not use any eye medications without the recommendation of a veterinarian.
  8. Take the container of the chemical with you or write down the text of the label.

When should you see a vet sooner?

Urgency from orange to -> red in cases of airway irritation from fumes, severe pain response, cloudy cornea, or general symptoms.

Diagnosis

The diagnosis of an eye burn is made by a thorough ophthalmological examination, ideally performed by a veterinarian with experience in veterinary ophthalmology. As this is an emergency, a medical history is taken first, in which the pet owner is asked about possible contact with chemicals. Information about the type of chemical is particularly valuable, which is why pet owners should bring the container of the suspected substance for veterinary examination.

The clinical examination begins with a careful inspection of the eye area and the visible eye structures. Due to the pain, local anesthesia with eye drops is often necessary to allow a detailed examination. The anterior segments of the eye are examined closely with a slit lamp to assess the extent of the damage.

A fluorescein staining test is performed to assess corneal integrity. Damaged corneal tissue absorbs the dye and appears green under blue light, making defects visible. If deeper damage is suspected, tonometry can be performed to measure intraocular pressure, as burns can lead to pressure changes.

Determining the pH value of the eye surface using special test strips can provide information about the type of corrosive substance and is particularly important if the causative chemical is unknown. Deviations from the physiological pH value of the eye (about 7.4) indicate remaining corrosive substances.

In severe burns, further imaging such as ultrasound or OCT (Optical Coherence Tomography) may be necessary to assess the full extent of the damage, especially if deeper eye structures may be affected.

Further veterinary measures

Introduce your animal to a veterinarian immediately. Eye burns are an ophthalmological emergency!

The treatment of eye burns in dogs and cats requires a rapid and systematic approach. Initial care ideally begins with the pet owner immediately and extensively flushing the affected eye. This should be done with plenty of lukewarm water or physiological saline solution for at least 15–20 minutes. It is important to position the animal’s head so that the rinsing liquid flows from the affected eye to the unaffected eye to avoid contamination of the healthy eye.

In veterinary practice, rinsing is intensified and continued under controlled conditions. Special eye rinsing solutions with a physiological pH value are used. In the case of burns caused by alkalis, longer rinsing of up to 60 minutes may be necessary, as these penetrate deeper into the tissue. After rinsing, the pH value of the eye surface is checked and rinsing is continued if necessary until a physiological value is reached.

Drug therapy includes several components: Topical antibiotics in the form of eye drops or ointments are used for infection prophylaxis, as the damaged cornea is more susceptible to bacterial infections. Broad-spectrum antibiotics such as ofloxacin or chloramphenicol are often used. Non-steroidal anti-inflammatory drugs (NSAIDs) are administered locally and systemically to relieve pain and reduce inflammation. In severe burns, corticosteroids may also be used under strict veterinary supervision to dampen the inflammatory reaction.

To support the healing of the cornea, tear substitutes / artificial tears and, if necessary, collagenase inhibitors are used to slow down the breakdown of the corneal tissue. In the case of deeper corneal defects, special bandage contact lenses or temporary nictitating membrane flaps can be attached to promote healing.

In severe cases with corneal perforation or extensive tissue destruction, surgical interventions such as conjunctival flaps, corneal transplants or, as a last resort, even enucleation (removal of the eyeball) may be necessary.

Prognosis and aftercare

The prognosis for eye burns depends largely on several factors: the type and concentration of the causative substance, the duration of exposure, the speed of initial care, and the extent of initial tissue damage. In general, the earlier the rinsing and veterinary treatment is carried out, the better the chances of recovery. Alkali burns often have a poorer prognosis than acid burns due to their deeper tissue penetration.

In the case of superficial burns with prompt treatment, the prognosis is usually good, and a complete restoration of vision is possible. In the case of moderate burns, corneal scars may remain, which can impair vision depending on their location and extent. Severe burns involving deeper eye structures can lead to permanent visual impairments or even loss of the eye despite intensive therapy.

Aftercare includes regular veterinary check-ups, initially daily, later at longer intervals. Medication must be administered strictly according to veterinary instructions, with the frequency of application being adjusted as healing progresses. The consistent use of eye drops and ointments is particularly important and often has to be carried out over several weeks.

To protect against self-injury, it may be necessary to wear a neck brace (Elizabethan collar). The animal’s environment should be designed to minimize the risk of injury, for example by removing obstacles in the event of impaired vision.

Long-term complications that can occur after an eye burn include chronic keratitis (corneal inflammation), symblepharon (adhesions between the conjunctiva and cornea), glaucoma (increased intraocular pressure), and cataracts (clouding of the lens). These require continuous veterinary monitoring and, if necessary, adjusted therapy.

Summary

Eye burns in dogs and cats are a medical emergency that requires immediate action. They are caused by contact with corrosive substances such as alkalis, acids, or organic solvents, which are contained in many household, garden, and car care products. Depending on the type of chemical, concentration, and duration of exposure, damage to the eye tissue can range from superficial irritation to deep, vision-threatening injuries.

The clinical signs include pain, blepharospasm, redness, swelling, increased tear flow, and corneal opacities. The diagnosis is made by a thorough ophthalmological examination, with the fluorescein test and pH value determination being important diagnostic tools.

Therapy begins with extensive rinsing of the eye, followed by drug treatment with antibiotics, pain relievers, and anti-inflammatory substances. In severe cases, surgical interventions may be necessary. The prognosis depends on the severity of the burn and the speed of treatment, with early intervention significantly improving the chances of recovery.

Aftercare includes regular veterinary check-ups and the consistent use of the prescribed medications. Preventive measures such as the safe storage of chemicals and the use of protective equipment when working with potentially dangerous substances are crucial to avoid eye burns in pets.

Outlook on current research

Research in the field of treatment of eye burns in small animals is constantly evolving. Current studies focus on innovative therapeutic approaches that promote healing and minimize long-term damage. A promising area is regenerative medicine with the use of stem cells for corneal regeneration. Mesenchymal stem cells have shown in experimental studies that they can accelerate corneal repair and reduce scar tissue formation.

Advances in biomaterials research have led to the development of new materials for corneal implants. Synthetic collagen matrices and biocompatible polymers offer alternatives to traditional grafts and can serve as scaffolds for tissue regeneration. These materials are also increasingly being used in veterinary ophthalmology.

The development of special eye rinsing solutions with chelate formers, specifically tailored to certain chemicals, could improve initial care. These solutions neutralize the corrosive substance more effectively than conventional rinses and can thus reduce the extent of tissue damage.

Advances in topical drug delivery through novel formulations such as hydrogels or nanoparticles enable a longer retention time and better penetration of the active ingredients in the eye. This could improve therapy adherence and optimize healing outcomes.

The further development of diagnostic imaging techniques such as high-resolution OCT (Optical Coherence Tomography) enables a more precise assessment of tissue damage and better therapy planning. These non-invasive procedures allow a detailed representation of the corneal layers and can accurately document the healing process.

Frequently asked questions (FAQs)

  1. Which household chemicals are particularly dangerous for my pet’s eyes?
    Particularly dangerous are highly alkaline products such as drain cleaners, oven cleaners and concentrated detergent. Battery acid, pool chemicals and concentrated cleaning agents also pose a high risk.
  2. How do I know if my pet has suffered an eye burn?
    Typical signs are sudden eye rubbing, severe blinking, eyelid spasm, redness, swelling, increased tear flow, and possibly a visible clouding of the cornea. The animal shows clear signs of pain and avoids bright light.
  3. What is the difference between a burn caused by acids and a burn caused by alkalis?
    Acids typically cause more superficial damage because they cause coagulation necrosis (clotting), which limits further penetration. Alkalis, on the other hand, lead to liquefaction of the tissue (colliquation necrosis) and penetrate deeper into the tissue. More severe long-term damage is often the result.
  4. Is tap water suitable for initial rinsing in the event of an eye burn?
    Yes, in an emergency, tap water is suitable for immediate rinsing. The most important thing is to act quickly and dilute and flush out the corrosive substance. Ideally, lukewarm water should be used.
  5. How long does healing take after an eye burn?
    The healing period varies depending on the severity of the burn. Mild superficial burns can heal within 1–2 weeks, while moderate to severe burns take several weeks to months and can leave permanent damage.
  6. Can my animal see completely again after an eye burn?
    With mild to moderate burns with prompt treatment, a complete restoration of vision is possible. However, severe burns can result in permanent visual impairment up to vision loss.
  7. What preventive measures can I take to avoid eye burns in my pet?
    Store all chemicals in closed cabinets, use child-resistant closures, do not leave open containers with chemicals, and keep your pets away when working with potentially dangerous substances.
  8. Are certain dog or cat breeds more susceptible to eye burns?
    Brachycephalic (short-headed) breeds such as pugs, French bulldogs, or Persian cats have anatomically protruding eyes that are less protected by the orbital cavity and may therefore be at higher risk.
  9. How often do the eye drops have to be used after a burn?
    The frequency of application is determined individually by the veterinarian and depends on the severity of the burn. In the acute phase, eye drops may be required every 1–2 hours, later the frequency is reduced.
  10. Can an untreated eye burn lead to loss of the eye?
    Yes, without appropriate and timely treatment, a severe eye burn can lead to irreversible damage that may require enucleation (surgical removal of the eye).

Literature

  • https://www.augenaerzte-aarau.ch/veraetzungen-der-augen/
  • Löwe, G. and Löwe, O., 2021. Emergencies in dogs and cats – A veterinary Guide. Kreuztal: Kynos-Verlag.
  • Merck & Co., 2020. Merck Veterinary Manual. 11th Edition. Kenilworth: Merck Publishing.
  • Ledbetter, E.C. and Gilger, B.C. (2021). Diseases and Surgery of the Canine Cornea and Sclera. In: Gelatt, K.N., Ben-Shlomo, G., Gilger, B.C., Hendrix, D.V.H., Kern, T.J. and Plummer, C.E. (Eds.) Veterinary Ophthalmology. 6th Edition. Hoboken: Wiley-Blackwell, S. 1082-1164.
  • Esson, D.W. (2020). Clinical Atlas of Canine and Feline Ophthalmic Disease. Hoboken: Wiley-Blackwell.
  • Schrage, N. and Struck, H.G. (2016). Guideline for the treatment of burns and scalds of the eyes and eyelids / Burns and scalds of the eyes: Recommendations for treatment. Working Group of Scientific Medical Societies (AWMF).