Parents, ophthalmologists should be aware of ocular exposure to hand sanitizer
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In a nearly 5-month period in mid-2020, seven times more pediatric cases of alcohol-based hand sanitizer ocular exposures were recorded compared with the previous year, according to a study in France.
A retrospective case series from April 1 to August 24, 2020, found a 9.9% rate of alcohol-based hand sanitizer ocular exposures reported to French poison control centers compared with 1.3% in 2019 (P < .001), as well as more admissions to an eye hospital for exposures (16 cases in 2020 vs. one case in 2019) (P < .001). However, the proportion of calls to the poison control centers due to chemical agent ocular exposures was lower in 2020 than 2019.
Healio/OSN spoke with Anna P. Murchison, MD, MPH, director of the Wills Eye Emergency Department and an oculoplastics surgeon at Thomas Jefferson University Hospital, who said there have been no cases of alcohol-based hand sanitizer ocular exposures among pediatrics at Wills Eye, but parents and ophthalmologists should stay vigilant.
OSN: What are the potential dangers for children who get hand sanitizer in their eyes?
Murchison: There are two potential ocular dangers, chemical and mechanical. If the applicator or container hits the eye or eyelid, there is potential for contusion or abrasion injury. More common is the chemical injury from the sanitizer. The main chemical of concern is the ethanol in alcohol-based sanitizers. The ethanol component can range from 60% to 95%, leading to an alkali burn of the eye and/or eyelids. Alkali injuries to the eye are generally more damaging than acid injuries, as there is deeper penetration. The damage can include surface irritation and pain to abrasions of the cornea, damage to stem (healing) cells of the front of the eye, scars of the cornea and scars of the inside surface of the eyelid.
OSN: What advice do you have to keep dangerous chemicals out of the eyes of children?
Murchison: Age-appropriate teaching about hand washing and sanitizing is helpful. Chemicals, including sanitizers, should not be handled by children without adult supervision. Signs placed near public hand sanitizers can also be helpful, along with dispensers located at a lower height for children or those in wheelchairs.
OSN: Does this study have any implications on the way you might handle patient education for potentially harmful substances?
Murchison: Chemical injuries to the eye can come from a variety of sources and are, unfortunately, not new. The need for education on proper use and storage of any chemical as well as the need to rinse the eyes and seek professional care if there is any chemical eye injury remain the important messages.
OSN: What pieces of information are important for patients and ophthalmologists potentially dealing with this?
Murchison: There is a need to educate patients and parents on the proper use and caution with hand sanitizers.
OSN: What is the best course of action for someone who gets hand sanitizer in their eyes?
Murchison: Patients should rinse the eyes, remove contact lenses if able and seek professional care for any chemical eye injury.
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