What treatment is most appropriate for a chemical eye burn caused by an alkali substance?

Irrigation with saline is the most appropriate treatment for a chemical eye burn caused by an alkali substance because alkali burns can lead to severe and progressive damage to the ocular tissues. The immediate and most important step in managing such burns is to thoroughly irrigate the eye to remove the chemical agent and reduce the pH to normal levels. Saline is commonly used for this purpose because it is isotonic and does not further irritate the eye.

The long duration of exposure to alkali substances can result in corneal opacification and permanent visual impairment; therefore, prompt and adequate irrigation is critical. The irrigation should continue for at least 30 minutes using copious amounts of saline or water to ensure complete washing away of the harmful agent.

Other potential treatments, such as instilling corticosteroid drops, may be considered later in management, particularly for controlling inflammation, but they are not immediate interventions after the burn occurs. Neutralizing an alkali burn with an acidic solution is inappropriate and could cause further tissue damage. The use of local anesthetic drops may relieve pain, but it does not address the need for immediate irrigation and is not a definitive treatment for the chemical injury itself. Hence, focusing on irrigation is the primary goal in the acute setting