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Updated: Jul 5, 2026

Nasolacrimal Lavage as a Treatment for Ocular Surface Toxic Soup Syndrome
Published on: April 25, 2025
Rinsing with isotonic saline solution for eye burns should be avoided
Safwan Rihawi1, Markus Frentz, Martin Reim
1Department of Ophthalmology, University of Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. rihawisafi@yahoo.de
Background:
Recent approaches to emergency treatment of eye burns have given rise to many questions on the effectiveness of traditional rinsing solutions. This led us to study the use of isotonic saline solution and a recently introduced, highly effective solution, Cederroth Eye Wash, in the initial treatment of eye burns.
Methods:
A central area (Ø 10mm) of the cornea of isolated ex vivo rabbit eyes was burnt for 20s with 25+/-1.4 micro L of 2N NaOH. The anterior chamber pH was measured continuously via microelectrode. The corneas were immediately rinsed for 15 min with flow rates of 50, 100, 200, 300, 400, and 500 mL/min.
Results:
After 20 min measurement, no significant differences in intraocular pH were found between unrinsed eyes and eyes rinsed with isotonic saline solution at any flow rate. At all flow rates, Cederroth Eye Wash brought about a significant decrease (p<0.001; Tukey t-test).
Conclusions:
Isotonic saline solution was ineffective in the emergency treatment of severe alkali eye burns in this ex vivo rabbit eye model. Cederroth Eye Wash, even at the lowest flow rate, significantly reduced intracameral pH. Thus a small amount of buffer solution effectively decontaminated the eye, whilst large amounts of saline solution did not.
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