Chemical injuries of ocular are included in the most urgent of ocular emergencies. Bad effect severity depends on the solution pH, time of contact, quantity of solution, and ability to penetrate into ocular. Solution pH can be acidic or alkali.

Alkali burns are usually more destructive that react with fats to form soaps, which damage cell membranes, destroy the cell structure, epithelium, stroma and endothelium which allowing further penetration of the alkali into the eye and may continue to penetrate the cornea long after the initial trauma.

In most case, acids cause less severe or more localized tissue damage. The corneal epithelium provides limited protection against weak acids, and little damage occurs unless the pH is 2.5 or less. Most stronger acids precipitate tissue proteins, making a physical barrier against their further penetration. Strong acids quickly cause the cornea and conjunctiva become white and opaque.

The characteristics of mild acid or alkali burns are conjunctival injection, become swelling and there is mild corneal epithelial erosions. The stroma of cornea may be mildly edematous, and it may identify mild to moderate cell and flare reactions on the anterior chamber.

The epithelium of cornea may slough  and  it leaves a relatively clear stroma which appearance may initially mask the burn severity. Corneal opacification are characteristics of extreme alkali burn.

Emergency treatment of a chemical burn begins immediate irrigation with water, normal saline.

• Fast, the patient especially with alkaline trauma needs fluid large amounts irrigation of the eye affected,. While still irrigating, local debridement and removal of foreign particles should be done. Irrigation should continue for at least 30minutes or until 2L of irrigant has been instilled in mild cases. In severe cases for 2–4hr or until 10L of irrigant must had been instilled.
• pH test paper can help in determining if the type of the chemical injury is not known.
  
  
• It must be identify immediately that the pH should be within a normal range, Ph 7.3–7.7 and after doing irrigation, the pH should be checked again approximately 30min to make certain that it has not changed.

Using of Topical corticosteroids should be done with caution.

Treatment with prednisolone 1% drops 4-9 times per day and scopolamine 0,25% drops 2-4 times per day may also needed in more severe chemical injuries.  The patient must refer to eye physician within 24-48hr for severe acid or alkali injuries of the eye, identified by very noticeable chemosis, limbal blanching, and/or opacification of cornea that can have infection of the cornea, glaucoma and possible loss of the eye as the result. (the doctor [b3ty])