CLEARED (Chemicals and Litmus testing with Effective Alkaline Range for Eye Damage): A Prospective, Interventional Study

Mark P. Breazzano, H. Russell Day, Sarah Tanaka, Uyen Tran

Research output: Contribution to journalArticlepeer-review


Objectives: While immediate diagnosis and irrigation is standard chemical eye burn practice, it is unknown to what extent specific pH measurements influence management, given the frequent clinical availability of narrow-spectrum nitrazine pH strips. We hypothesize that exclusive broad-spectrum pH strip implementation leads to more accurate measurement and expedited ophthalmologic consultation. Methods: At a Level I trauma center over 25 months, all emergent adult ophthalmology consultations for chemical burns were included in a pre-intervention (n = 22) and post-intervention (n = 20) study design. During this time, narrow-spectrum nitrazine pH strips available to non-obstetric emergency department (ED) staff were exclusively replaced by broad-spectrum strips. Causative chemical, time from triage to ophthalmology consultation, examination findings, ocular pH by ED and ophthalmology staff, and irrigation quantity were analyzed. Results: Most burns were alkaline. Time from triage (p = 0.043) and irrigation quantity following consultation (p = 0.047) each decreased following exclusive ED implementation of broad-spectrum pH strips. There was greater pH congruence between consulting and primary physicians after intervention (p = 0.03). Conclusions: Exclusive non-obstetric implementation of broad-spectrum pH strips may allow greater accuracy and faster management of ocular chemical burns. Availability of narrow-spectrum pH strips may be dangerous clinically by falsely reassuring the examiner with inherent inaccuracy.

Original languageEnglish (US)
Pages (from-to)796-802
Number of pages7
JournalAcademic Emergency Medicine
Issue number7
StatePublished - Jul 2019
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine


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