The initial action in the event of accidental eye contact with a cytotoxic agent is:

• A. Obtaining an ophthalmologic examination
• B. Providing written documentation of the event
• C. Reporting the incident to the local poison control center
• D. Irrigating the eye with isotonic solution for at least 5 minutes

Answer: (D)

Immediate irrigation of the eye with a normal saline–type solution is the first step because it directly dilutes and removes the cytotoxic agent before it can cause further tissue damage. The cornea and surrounding structures are highly sensitive, so flushing starts the injury-control process right away, reducing the amount of chemical that can penetrate and injure the epithelium. Using isotonic solution is important because it matches the eye’s natural osmolarity, avoiding additional irritation that could come from hypotonic or hypertonic fluids. The goal is to rinse for several minutes (at least five) to wash away as much chemical as possible; longer irrigation may be needed depending on the agent and symptoms. After the initial flush, pursue ophthalmologic assessment and report the incident according to protocol, but the key immediate action is the eye irrigation.