An Abu Dhabi doctor has sent out a hand sanitiser safety warning to parents after a four-year-old girl suffered a serious injury after being accidentally splashed in the eye with the gel.
The child activated a foot-operated dispenser to clean her hands only for a large amount of the sanitiser to squirt into her eye.
She immediately screamed out in pain, prompting her parents to rush her home to attempt to wash out the sanitiser before taking her to Cleveland Clinic Abu Dhabi.
“For purposes of hygiene, we’ve taught our daughter to use soap and water for washing her hands and to only use sanitisers if soap and water are not available, but because she saw everyone around her use it, she ran up ahead from us to use it too," said the girl's mother, who asked to remain anonymous.
"When she pressed the pedal of the dispenser, the hand sanitiser didn’t fall downwards but instead a large amount went straight into her eye and she began screaming in pain."
Injuries similar to a 'chemical spill'
Dr Brian Armstrong, a staff physician at Cleveland Clinic Abu Dhabi, said her injuries were comparable to those suffered by workers exposed to toxic material or who were victims of a chemical spill.
He said while it was the first such incident he had encountered in Abu Dhabi, such injuries have been on the rise across the globe due to the prevalence of hand sanitisers during the Covid-19 pandemic.
The child, who was unable to open her eye and in extreme pain when she arrived at the clinic, was diagnosed with a near total corneal abrasion caused by the alcohol and alkaline chemical additives in the hand gel.
Doctors immediately washed the solution from the child’s eye, administered antibiotics to prevent infection and pain drops to reduce discomfort.
But her pain continued to increase.
After a couple of days she was taken to the clinic's operating room where doctors evaluated her eye under anesthesia and placed a self-retaining amniotic membrane, or biological bandage, used to heal large non-healing corneal abrasions.
Doctors removed the amniotic membrane from the child a week after it was placed and found the corneal abrasion to be completely healed.
Earlier this year, the French Poison Control Centres reported seven times more cases of ocular exposure among children to hand sanitisers between April and August in 2020 compared to the same period in 2019.
Dr Amstrong said hand sanitiser stations installed in public places posed a particular risk to young children.
Sanitiser stations a safety risk for children
“Hand sanitiser dispensers installed in public spaces are often at waist-level for adults but this means that they are at eye-level for children," Dr Armstrong said.
"So, the chances of a child getting splashed in the eye are quite high. Most hand sanitisers have a high concentration of alcohol, which starts to break down the surface of the cornea immediately.
"We use it in very measured doses to treat the cornea in very specific instances, so we know just how effective it can be.
“This is the kind of injury we would typically see among workers who are exposed to toxic materials or a chemical spill on a worksite," Dr Armstrong said.
"Delayed treatment of such injuries can have even worse repercussions in children compared to adults because their vision is still developing at such a young age.”
The doctor advised parents to ensure their children use soap and water instead of hand sanitiser whenever possible.
“If this is not possible, parents should use neutral and natural hand sanitizing solutions under strict supervision and teach their children to use only a small amount making sure it completely dries prior to touching their eyes.
"If they happen to rub their eyes with sanitiser, immediately wash it out with water and visit a hospital if there is blurred vision or pain,” he said.
The young girl is now well on the road to recovery and the clinic will continue to monitor her progress.
The child’s mother says the positive outcome was a result of swift action by them and the hospital.
“If treatment was delayed, this could have caused permanent vision damage.
"I really appreciate the prompt response of the emergency and ophthalmology teams at Cleveland Clinic Abu Dhabi and thank them for the attention and care that helped save my daughter’s eye,” she said.