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Water: Still the best eyewash flushing fluid

By Rob Wolff, MD
January 11, 2009


(Original feature unedited)



We all learn in middle school that the human body is composed of over 90% water. Bread may be the staff of life, but water washes it down! Water is a great natural elixir. Later in life, most of us come to realize that sometimes the best remedies are the natural ones. Now, while I’m certainly not a homeopathic zealot, I know a good thing when I see it! And, water is a good thing. I’m sure few of you would argue that point.

As it relates to irrigating one’s eyes, much has been said lately about alternatives to the good old-fashioned eye bath using pure, fresh water. Almost any chemical splash into the eye will increase either alkalinity or acidity. That’s simply a function of chemical burning. Alkalinity increases the pH of the eye’s surface from its normal level of 7.4, whereas acidity decreases the pH. It all begs the question of how best to bring pH in the eye back to its natural state. The answer hasn’t changed over the years: Copious amounts of water. Those “neutralizers” that some folks are offering as the greatest thing since sliced bread do nothing more than create a chemical reaction in your eye… and, as we all know, most chemical reactions create heat. So, where do you want a chemical reaction, in a Petri dish or in your eye? Easy answer, right? Get the foreign material out of your eye as quickly as possible, without attempting to change its state, because more often than not the chemical reaction surrounding that change will create heat and may have further toxic effects on the eye.

Likewise, there is significant conjecture about using municipal water versus using sterile saline solution in industrial and commercial eyewashes. In my opinion, the best answer to this question comes as the result of answering another question: What type of eyewash apparatus is being used? The answer to that question ultimately determines which flushing fluid is the best.

Permanent eyewashes
For permanent eyewash installations in industrial and/or commercial operations where municipal water is readily available, the best flushing fluid is pure clear water. It has several significant benefits versus packaged sterile saline cartridges:
  • As noted above, water is a great natural remedy, especially to burns in sensitive areas of the body such as the eyes. And, water that is protected by the miniscule amount of residual chlorine left in municipal water most undoubtedly will be bacteria-free.
  • Plumbed-in emergency equipment products must be tested weekly by activating the flow. This cleans out the passageways that deliver the water and makes certain that the equipment is ready for use in an instant. That can’t be done with a sealed container product, as once it’s activated you must replace the expensive, one-use cartridges.
  • Eyewashes must, by the nature of their applications, be readily available for multiple concurrent injuries or subsequent events. Once you’ve used the packaged sterile saline products for a single irrigation use, they must be replaced before the next use. That’s fine if you ordered replacements in advance, but at between $120 and $170 per refill, with a shelf-life product, few businesses will have replacements right there at each installation ready for the next use. And, you’re completely unprotected while you await delivery of the replacement cartridges. The ANSI standard doesn’t “cut you any slack” because you’re waiting for new cartridges to be delivered.
  • Most important, plumbed-in water systems ensure that water is immediately available in an emergency, whereas sealed container products may take a small amount of time to set up, assuming that they are readily at hand and not hidden away. And time is of the essence in a chemical splash. There are very few true eye emergencies where time is critical, and chemical eye injuries are true eye emergencies where minutes and even seconds may make a big difference in saving someone’s eyesight.
Portable eyewashes
Portable eyewash products are a different story. In these instances, the assumption is that pure municipal water is not readily available, so temporary measures must be taken. This entire situation is more difficult to control and some concessions must be made. The concession is in the area of multiple or subsequent need failures.

Two types of products are available, sealed container (mostly sterile saline cartridge) products and refillable (open to the air) designs. Either type of product can be effective, with personal preference playing the determining factor.
  • Both have the single use drawback, with the cartridge re-order issue of the sealed container products typically taking the longest time to refill. Obviously, the sealed container cartridge price is another drawback, which can at times be exacerbated by inadvertent or malicious activation.
  • The refillable (open to the air) designs require additive to be put into each refill to preserve the water for the life cycle of the refill (usually six months).
In the end, the best advice I can give users is to use common sense and trust the old-fashioned remedy to eye irrigation needs. Medical professionals use sterile saline in our offices, but we do not have to irrigate for 15 minute cycles and the “real world” of plant operations has many challenges we do not face in our offices.

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Dr. Wolff is a Board Certified Ophthalmologist and principal of the Sierra Nevada Eye Center, Ltd. He received his medical degree from Vanderbilt University in Nashville, Tennessee in 1991. Subsequently, he completed his ophthalmology training at the University of Minnesota in 1995, during which time he received the prestigious Minnesota Sight and Hearing Association Research Award. Dr. Wolff’s ophthalmology practice has offices in Carson City and Reno, Nevada.

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