Getting household bleach in your eye is a serious medical emergency that requires immediate action to prevent permanent vision loss. The chemical nature of this common cleaning agent means it begins damaging delicate eye tissue in a matter of minutes, making the initial response critical. A splash of bleach, which contains sodium hypochlorite, can cause a severe chemical burn, and rapid intervention is the only way to minimize potential injury.
Immediate First Aid Steps
The most important step is to begin flushing the affected eye immediately with clean water. Do not waste time looking for a specialized eyewash station; use the nearest source of running, lukewarm tap water, a shower, or a clean container of water. Position your head so the water flows continuously from the inner corner of the eye (near the nose) outward, preventing the chemical from running into the unaffected eye.
Hold the eyelids open with your fingers to ensure the water reaches all surfaces of the eye, even if pain makes this difficult. The goal is to dilute and wash away the caustic substance. This continuous irrigation must be maintained for a minimum of 15 to 20 minutes to be effective.
If you wear contact lenses, attempt to remove them while the eye is being irrigated, as they can trap the chemical against the corneal surface. Do not rub the eye, as this can spread the chemical and cause further damage. After the 15-to-20-minute flushing period is complete, thoroughly wash your hands to remove any residual bleach.
Understanding Chemical Eye Burns
Bleach is dangerous because it is an alkaline substance, typically having a high pH level between 11 and 13. This is significantly higher than the eye’s natural, near-neutral pH. Unlike acids, which often cause a protein coagulation barrier that limits deeper penetration, alkaline substances like sodium hypochlorite are lipophilic and rapidly penetrate the eye’s tissues. This deeper penetration is known as liquefaction necrosis, where the chemical breaks down cell membranes and tissue structure.
The hydroxyl ions in the bleach saponify the fatty acids of the cell membranes, allowing the chemical to quickly move through the cornea and into the anterior chamber of the eye. This can damage internal structures like the iris, lens, and ciliary body within as little as 5 to 15 minutes of exposure. Immediate signs of injury include severe pain, intense redness, swelling of the eyelids, excessive tearing, and potentially blurred vision.
Seeking Professional Medical Attention
Once the 15-to-20-minute flushing period is complete, emergency medical care is required. Even if your symptoms seem to have cleared after rinsing, chemical damage may not be visible, and internal injury could still be present. Do not attempt to drive yourself to the hospital if your vision is impaired; arrange for transportation or call for emergency services. Inform the medical staff exactly what chemical you were exposed to, ideally by bringing the bottle or a picture of the label.
Professional Treatment and Recovery
Upon arrival at the emergency department or eye clinic, the medical team will often continue irrigation using sterile solutions to ensure the chemical is removed. Anesthetic drops will be administered to numb the eye, allowing the doctor to examine the damage and test the eye’s pH level. Irrigation continues until the ocular surface pH returns to a normal range. Further treatment involves a regimen of prescription eye drops.
Topical antibiotics are commonly used to prevent secondary infections, while cycloplegic drops are administered to dilate the pupil and relax the internal eye muscles, which helps reduce pain and inflammation. In severe cases, topical steroids may be prescribed to control inflammation.
Steroid use must be closely monitored by an ophthalmologist due to the risk of complications. Follow-up appointments are essential to monitor for potential long-term complications, which can include corneal scarring, cataracts, or chronic glaucoma due to damage to the eye’s drainage structures.