The SINGLE MOST IMPORTANT immediate management step for a chemical eye injury (acid or alkali) before any other assessment is:

• A Instil topical anaesthesia and measure pH of the fornix
• B Immediate referral to an ophthalmologist for Roper-Hall grading
• C Topical steroid drops to reduce inflammatory damage
• D Copious and continuous irrigation of the eye with normal saline or Ringer's lactate for at least 30 minutes ✓

Explanation

Immediate and prolonged irrigation is the most critical first-aid measure for chemical eye injuries; it must start at the scene using any available clean water and continue with saline/RL at the hospital until conjunctival pH is 7.0–7.5. Alkalis continue to penetrate rapidly (saponification of fatty acids), so delay costs vision. pH testing and steroid application are secondary to irrigation. Referral should never delay irrigation.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.