Accidental exposure of the eye to alcohol, whether from a high-proof spirit or hand sanitizer, is a common ocular emergency requiring rapid intervention. The delicate tissues of the eye are highly sensitive to chemical irritants, and concentrated alcohol can cause significant damage to the ocular surface. Understanding the correct, immediate response is paramount to preventing potential long-term complications. The goal is to quickly dilute the chemical and minimize the contact time between the alcohol and the eye’s surface structures.
Essential Immediate Steps
The single most important action to take after getting alcohol in the eye is to begin flushing the area immediately with a large volume of clean water. Do not waste time searching for a sterile eyewash solution if clean, running tap water is readily available, as the speed of irrigation is paramount. You must flush the eye for a minimum of 15 to 20 minutes to ensure the chemical is adequately diluted and removed from the ocular surface.
If you are wearing contact lenses, attempt to remove them immediately before or during the flushing process, as they can trap the alcohol against the cornea and worsen the injury. To effectively flush the eye, use lukewarm water from a shower or a gently running faucet, aiming the stream at the forehead or the bridge of the nose so the water runs into the affected eye. You should tilt your head so the water flows away from the unaffected eye, preventing the alcohol from spreading.
It is necessary to hold the eyelids open during the entire irrigation period, as the natural reflex is to keep the eye tightly shut. While flushing, you should move the eye in all directions—up, down, and side to side—to ensure the water reaches all parts of the eye and flushes out any trapped chemical. The water flow should be steady and gentle, not so forceful that it causes additional pain or trauma.
How Alcohol Affects Eye Tissue
Alcohol causes pain and potential injury because it acts as a chemical irritant and a desiccant, damaging the superficial layers of the ocular surface. The primary targets of this injury are the cornea, the transparent outer layer, and the conjunctiva, the thin membrane covering the white of the eye and the inner eyelid. Exposure leads to a process known as protein denaturation, where the alcohol chemically alters the proteins in the eye’s cells.
This denaturation is similar to a chemical burn, causing immediate cell death, or lysis, in the corneal epithelium. High-concentration alcohols, such as the 60% to 95% ethanol or isopropanol found in hand sanitizers, are particularly damaging. The severity of the resulting keratitis, or corneal inflammation, depends directly on the concentration of the alcohol and the duration of exposure.
Ethanol and isopropyl alcohol, the two most common types, both induce this cytotoxic effect, leading to the breakdown of the corneal epithelial barrier. The destruction of these outer cells is what triggers the intense burning sensation, redness, and tearing. The alcohol also draws moisture out of the tissue, exacerbating the irritation through dehydration of the ocular surface.
When to Seek Professional Medical Care
Immediate professional medical evaluation is necessary if pain or discomfort persists for more than a couple of hours after the initial 15-to-20-minute flushing procedure. Persistent, sharp pain or a feeling that a foreign body is still present are strong indicators of potential underlying damage that requires an ophthalmologist’s assessment. You must monitor for other symptoms over the next several hours, even if the initial pain subsides.
Signs such as continuously blurred vision, increased sensitivity to light (photophobia), or a visible cloudiness on the cornea indicate a more severe chemical injury. If the redness is intense and does not decrease significantly, or if there is a noticeable change in the eye’s coloration, seek emergency care immediately. These symptoms suggest a deep epithelial defect or damage to the underlying corneal layers.
A medical professional will perform a thorough eye examination, often using fluorescein dye to visualize the extent of the damage to the corneal surface. They may perform additional irrigation, check the pH level of the eye to ensure all chemical residue is gone, and assess the degree of injury. Treatment for a confirmed corneal abrasion or defect may include prescription antibiotic drops or ointments to prevent infection while the tissue heals.