In a chemical burn to the eye, what is the immediate priority?

• A. Patch the eye
• B. Administer analgesics
• C. Copious eye irrigation
• D. Apply topical antibiotics

Answer: (C)

The immediate priority in a chemical burn to the eye is copious irrigation to flush out the chemical, dilute it, and help restore the ocular surface pH toward normal. Chemicals keep harming the eye as long as they remain, so rapid flushing with clean water or isotonic saline is essential to minimize tissue damage. This should be done right away, with the eyelids gently held open and irrigation directed from the inner corner toward the outer, continuing until the pH is near neutral (about 7.0–7.4) and there is no ongoing irritation. Remove any contact lens if present, and seek urgent ophthalmology input after or during irrigation.

Analgesia can be provided for comfort, but it doesn’t stop the chemical injury, so it isn’t the priority. Patching the eye isn’t performed initially because it can mask injury assessment and delay treatment. Topical antibiotics help prevent infection but do not address the ongoing chemical damage, so they’re not the first action.