The document discusses ocular chemical burns and the importance of prompt irrigation. It emphasizes that copious irrigation is the most important treatment and may influence the outcome more than any other approach. The Morgan Lens is introduced as the world's leading method for ocular irrigation, providing effective and easy irrigation to treat chemical burns, burns, irritants and foreign bodies. It requires 2 lenses, delivery tubing, IV solution and collection devices to irrigate both eyes until the pH returns to normal, for at least 20-30 minutes for irritants and 2 hours for strong alkalis.

1. -Ocular Chemical Burns-
“Chemical burns to the eye are among the
most urgent of ocular emergencies…
Copious irrigation is the most important
emergency treatment of the
chemically-burned eye…
This procedure probably has more of an
influence on the outcome of the injury than
any other therapeutic approach.”
“Prompt Irrigation of Chemical Eye Injuries May Avert Severe Damage”,
Frank R. Burns, MD Occupational Health & Safety, April, 1989

2. The Morgan Lens®
The World’s Leading Method of Ocular Irrigation
• Effective, easy to use ocular
irrigation
• Frees medical personnel to treat
other injuries
• Developed by a practicing
ophthalmologist
• Used in 95% of U.S. emergency
departments

3. Uses of the Morgan Lens
• Alkali Burns
• Acid Burns
• Thermal Burns
• Irritants (gasoline, detergents, etc.)
• Non-embedded Foreign Bodies
• Foreign Body Sensation With No Visible Foreign
Body
• Routine Pre-Operative
• Eyelid Surgery
• Severe Infection

4. Alkali Burns (Bases)
• Most Serious of all Ocular Burns
• Penetrate Rapidly, increasing pH of anterior chamber
• Can cause severe damage to collagen, nerve endings,
keratocytes, iris, and ciliary body
• Loss of corneal epithelium leads to increased risk of
infection
• Common Sources That Contain Alkali:
– Lye (in drain cleaners)
– Lime (in plaster, cement)
– Ammonia (in fertilizers, cleaning agents)
– Motor vehicle airbags

5. Acid Burns
• Immediately denature proteins
– opacifies cornea which slows deep penetration
• Eye initially may look worse than alkali burn
although damage often is not as severe
• Common Acids:
hydrofluoric sulfuric
sulfurous hydrochloric
nitric acetic
• Most Common:
– Industrial accidents and automobile battery explosions
• Hydrofluoric Acid Burns-very serious
– Penetrate quickly and act like alkali burns

6. Irritants
• Cause more discomfort than actual damage
• Common Irritants:
– Gasoline
– Pepper Spray
– Household Detergents
Irritants are substances with a neutral pHIrritants are substances with a neutral pH

7. Materials Necessary for Irrigation
with The Morgan Lens
• 2 Morgan Lenses
Note: Pain in one eye may mask pain in other--irrigate both unless injury is
known to be limited to one eye.
• Morgan Lens Delivery Set®
• I.V. Solution (lactated Ringer’s recommended)
• Medi-Duct®
or towels to absorb outflow
• Topical ocular anesthetic if available
• pH paper

8. INSERTION
Step One:
• Instill topical ocular
anesthetic (if available)
• Attach Morgan Lens to
Morgan Lens Delivery Set
or syringe or I.V. tubing
**If possible, remove contact lenses (if necessary) BEFORE starting irrigation. IrrigateIf possible, remove contact lenses (if necessary) BEFORE starting irrigation. Irrigate
over contacts if unable to remove. Removal may be easier after a period of irrigation.over contacts if unable to remove. Removal may be easier after a period of irrigation.

9. INSERTION
• Have patient look down
• Insert Lens under upper lid
• Have patient look up, retract
lower lid, drop Lens in place
*Solution acts as a cushion, suspending the Lens above the cornea and protecting*Solution acts as a cushion, suspending the Lens above the cornea and protecting
injured surfaces from the eyelids.injured surfaces from the eyelids.
Step Two:Step Two:
Start Minimal FlowStart Minimal Flow
BEFORE* Inserting LensBEFORE* Inserting Lens

10. INSERTION
Step Three:
• Secure a fluid collection
device such as the Medi-Duct
to the side of patient’s face
• Continue irrigation until pH
of eye returns to normal
DO NOT RUN DRY
Tape tubing to patient’s forehead to prevent accidental removalTape tubing to patient’s forehead to prevent accidental removal

11. REMOVAL
• Continue flow
• Have patient look up
• Retract and hold lower lid
• Slide Morgan Lens outSlide Morgan Lens out
TERMINATE FLOWTERMINATE FLOW

12. Irrigation Times
*Recommendation from*Recommendation from Goldfrank’s Toxicologic EmergenciesGoldfrank’s Toxicologic Emergencies
•For Irritants:
-20 to 30 minutes minimum
•For Acids and Alkalis:
-Irrigate with 2 liters fluid per eye-Irrigate with 2 liters fluid per eye
-Wait 5-10 minutes-Wait 5-10 minutes
-Measure pH of cul-de-sac-Measure pH of cul-de-sac
-Repeat until pH is between 7.5 and 8-Repeat until pH is between 7.5 and 8
For strong acids or any alkali, continue irrigation for 2 hoursFor strong acids or any alkali, continue irrigation for 2 hours
after reaching surface pH of 8 to ensure neutralization ofafter reaching surface pH of 8 to ensure neutralization of
anterior chamber*anterior chamber*

13. Questions for Patients
Do NOT delay irrigation to take patient history*
• When did injury occur?
• What substance was involved?
• Is the patient on any medication or allergic to any medications?
• Was the patient wearing safety glasses when injury occurred?
• Are there any other injuries?
• Did patient receive any prior treatment?
From Nursing 2000, Volume 30, Number 8
**If possible, remove contact lenses (when necessary) BEFORE starting irrigation butIf possible, remove contact lenses (when necessary) BEFORE starting irrigation but
DO NOT DELAY irrigation--removal may be easier after a period of irrigation.DO NOT DELAY irrigation--removal may be easier after a period of irrigation.

14. Contraindications
• Protruding foreign body
• Penetrating eye injury
• Suspected or actual rupture of the globe
• Instilling anesthetic agents with known allergies

15. Lactated Ringer’s
vs. Normal Saline
MorTan recommends the use of lactated Ringer’s
• pH more like that of tears
– pH of tears: approximately 7.1
– pH of lactated Ringer’s: 6.0 to 7.5
– pH of Normal Saline: 4.5 to 7.0
• High buffering capacity
– lactated Ringer’s solution returns pH to neutral more quickly with either
acidic or basic contaminants*
• Increased patient tolerance
Normal Saline may cause discomfort and/or morphological changes*
*from independent studies

16. Suggestions for theSuggestions for the
““Difficult Patient”Difficult Patient”
Reassure patient: insertion willReassure patient: insertion will quicklyquickly relieve pain.relieve pain.
Any delay will cause further damage.Any delay will cause further damage.
Seconds count!Seconds count!
•Irrigating solution provides soothing sensationIrrigating solution provides soothing sensation
•Injured cornea is separated from “squeegie” action of eyelidsInjured cornea is separated from “squeegie” action of eyelids
•Eye may be closed during procedureEye may be closed during procedure
•Some chemicals generate heat when mixed with water-irrigation coolsSome chemicals generate heat when mixed with water-irrigation cools
Note: Cornea will not be touched by Morgan LensNote: Cornea will not be touched by Morgan Lens
Topical anesthetic may relieve anxietyTopical anesthetic may relieve anxiety
Note: Additional anesthetic may be instilled without removing Lens.Note: Additional anesthetic may be instilled without removing Lens.
Pinch tubing and instill drop into cul-de-sac.Pinch tubing and instill drop into cul-de-sac.

17. Benefits of the Morgan Lens
• 100% of irrigating solution is delivered directly
to cornea, cul-de-sac and conjunctiva
• Frees medical staff to attend to other injuries
• Patient can be ambulatory during irrigation
• Patient rests comfortably
• Highly cost effective

18. Summary
• Burns are among the most urgent of ocular
emergencies
• Copious irrigation must be started quickly (at
scene of accident if possible)
• All surfaces of eye (cornea, sclera, cul-de-sac, and
inner eyelid) must be flushed thoroughly
• Irrigation should be continued until pH of eye
returns to normal (alkali burns may require hours
of irrigation; severe infections may require
irrigation for hours or even days)
*See Morgan Lens Uses Chart available on MorTan’s website or from MorTan

19. The Morgan Lens
The Leader in Ocular Irrigation
• MorTan, Inc.
P.O. Box 8719
Missoula, MT 59807 USA
1-800-423-8659
1-406-728-2522
FAX 1-406-728-9332
www.morganlens.com
e-mail: mortan@morganlens.com
© 2002 MorTan, Inc. MorTan is an ISO 9001 registered company© 2002 MorTan, Inc. MorTan is an ISO 9001 registered company
Do not duplicate or modify without permission from MorTan, Inc.Do not duplicate or modify without permission from MorTan, Inc.
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20. Morgan Lens
Instructional Video
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Instructional Video.Instructional Video.
(Note: if the video does not play, double-click on “My Computer” and double-click on the icon for the CD-ROM. From there, open the file “mlvideo.mpg”)(Note: if the video does not play, double-click on “My Computer” and double-click on the icon for the CD-ROM. From there, open the file “mlvideo.mpg”)