Doctors have described how two children required medical care after getting hand sanitiser in their eyes.
Good hand hygiene is one of the key strategies to warding off the coronavirus, with the US Centers for Disease Control and Prevention stressing the gel must have at least a 60% alcohol content to kill the infection.
While people with skin conditions like eczema have long claimed the drying formulas exacerbate their symptoms, it is now emerging the alcohol-based rubs can cause problems if they get in children’s eyes.
Medics from the Grewal Eye Institute in Chandigarh, India, have reported how an unnamed four-year-old girl was brought in after she attempted to use a hand sanitiser dispenser in a shop.
The girl immediately developed severe light intolerance, with the doctors later discovering a “large defect in the central cornea”.
An unnamed five-year-old boy similarly developed pink eye and cornea damage one hour after getting hand sanitiser in his eyes.
While both youngsters recovered, the Grewal medics have stressed “small children are at risk of severe ocular injury and possibly even blindness due to inadvertent ocular exposure to ABHR [alcohol-based hand rubs].”
This comes as scientists have revealed the number of “alcohol-based hand sanitiser eye exposures” among children being reported to the French Poison Control Centers rose by seven times between April and August 2020, compared to the same period in 2019.
“Small children are at risk of severe ocular injury and possibly even blindness due to inadvertent ocular exposure to ABHRs,” the Grewal medics wrote in the journal JAMA Ophthalmology.
“In most public places, the hand sanitisers are installed at a waist-level height of an adult but at eye level or above for a young child.”
Ethanol – the chemical compound in alcohol – “is known to be highly toxic” to cells in the cornea, exerting an “immediate cytotoxic effect”.
“In both children in our case report, there were no long-term sequelae, but it is not hard to imagine a situation where care is delayed, increasing the chance of long-term corneal and ocular surface complications,” wrote the medics.
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Upon arrival at the eye institute, the four-year-old girl’s right eyelid was swollen with an excessive amount of fluid.
She also showed signs of eye irritation and blood vessel restriction to the organ’s tissues.
The medics also picked up on “a large epithelial defect in the central cornea sparing a 2mm rim of peripheral corneal”.
The girl was treated via “copious irrigation with balanced salt solution”. She was then given a series of eye drops to use over several days.
Her corneal defect “healed completely”, while the blood vessel restriction “resolved in two weeks”.
When the five-year-old boy arrived at the institute, medics diagnosed keratopathy; cornea damage due to dryness as a result of incomplete eyelid closure.
A “thorough saline wash” was carried out, followed by regular eye drops. His “ocular findings” resolved after five days.
Off the back of their case reports, the medics recommend children always be assisted by an adult when using hand sanitiser.
Regular hand washing with soap and water is also likely the safer option, and still effective against the coronavirus, they added.
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