Hand sanitizer is causing an epidemic of chemical burns to children's eyes

All that hand sanitizer people have been slathering on since the start of the COVID-19 pandemic has lead to more than just dry hands and eye-watering smells: More and more children are showing up to hospitals with hand sanitizer in their eyes, in some cases risking blindness.

In a paper published Thursday (Jan. 21) in the journal JAMA Ophthalmology, researchers working with data from the French Poison Control Center (PCC) found a sevenfold increase in that country in reports of kids getting hand sanitizer in their eyes. In 2019, hand sanitizer accounted for just 1.3% of all chemical eye exposure incidents in the pediatric database. By the end of 2020, that number was up to 9.9%. Just one toddler in France required hospitalization for sanitizer in his eyes in 2019. In 2020, 16 children were hospitalized for such chemical exposure. A second study in the same journal described two cases in India of small children getting hand sanitizer in their eyes, with serious consequences (though both made full recoveries after treatment).

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Hand sanitizer is so harsh on the eyes because it typically contains high concentrations of alcohol, typically in the form of ethanol, which can kill certain cells in the cornea, the researchers wrote. Small children seem especially vulnerable to this sort of injury because they stand at the right height to accidentally spray alcohol from a freestanding dispenser directly into their eyes. Some may also unwittingly rub the sanitizer into their eyes after applying it to their hands.

The biggest risk to kids might be from dispensers in public places, which tend to sit on stands right around a small child's eye level, the researchers found. Though just 16.4% of kids who got sanitizer in their eyes in France in May 2020 came in contact with the stuff in public, by August 2020 that number was up to 52.4%. 

"Children are naturally curious and great mimics," wrote New York University ophthalmologist Kathryn Colby in an editorial accompanying the two JAMA Ophthalmology papers. "With the current widespread use of hand sanitizer in public places, it is not unexpected that young children would be drawn to these dispensers, many of which appear to be inadvertently designed to facilitate contact between the hand sanitizer and young eyes."

When that contact happens, the consequences can be unpleasant. In the two Indian case reports, the kids showed up in the hospital in serious pain.

A 4-year-old girl who got sanitizer in her right eye at a shop the day prior to turning up in the hospital found light unbearable and had an eyelid swollen with fluid. There was also damage to the inner tissue of her eyelid and cornea. Her eye healed, however, after being washed out with saline solution in an operating room and getting eye drops every few hours for days.

A 5-year-old boy who showed up in the hospital just an hour after his exposure had similar damage to the inner lining of his right eyelid and some cells in his cornea had begun to die. However, he similarly healed after a saline wash and days of eye drops every few hours.

Not all children have been so lucky. According to the French database, two kids required transplants into their corneas of tissue taken from placentas in order for their eyes to properly heal.

To avoid this problem, the researchers wrote that it's probably best to stick with hand washing with soap and water, which is more effective than sanitizer anyway. And parents should take care to train their kids how to properly use dispensers. (They also suggested that stores should introduce sanitizing stations for kids at heights below a typical child's eye level.) 

If your child (or an adult) does get hand sanitizer in their eye, the Optometrists Network recommends immediately taking several steps:

• Don't let them rub their eyes. This should be avoided "at all costs" because it can make the problem worse.
• Wash out the affected eye for ten minutes with warm water. If possible, have them hold their heads under the tap so water can run into their eyes and out, flushing out the sanitizer.
• If burning and stinging continues, or if their vision changes or they experience vision loss, contact an eye doctor as soon as possible and treat the situation as an emergency. (If you don't have access to an eye doctor, go to an emergency room.) 

Colby wrote that the data shows it's time for a public awareness campaign to keep kids away from dispensers. Long-term, she wrote, the problem will hopefully lessen as the COVID-19 pandemic subsides.

Originally published on Live Science.