To fight against the coronavirus pandemic, many automatic dispensers of hydro-alcoholic solutions have been positioned at the entrance to the stores.

A retrospective study was initiated following the admission last week of three serious cases to the Adolphe-de-Rothschild Foundation Hospital, for eye damage due to splashing gels in children under 4 years old, requiring emergency surgery. Theophthalmologist Gilles Matin explains why several of his colleagues are calling for caution.

You are issuing an alert against the increase in serious eye damage caused by hydro-alcoholic solutions in children. What are your observations?

We are seeing an abnormal increase in eye burns in young children. Since the start of the coronavirus epidemic, we have had three cases of serious eye damage in our department alone. Normally, we have an average of one case per year.

Why are children more concerned than adults?

The devices set up at the entrance to public places for washing hands are dangerous for children. Indeed, they see adults press the pedal to release the hydro-alcoholic gel, so they do the same. However, because they are not tall enough, the product is projected directly into their eyes. The children most at risk from ophthalmic burns are those who measure between 1m and 1m20, so who are approximately between 3 and 9 years old.

What is serious eye damage and what can be the consequences?

Eye damage is serious when there is damage to eye tissue. This involves operating the affected child several times under general anesthesia, until the surface layer of the cornea heals and grows back. Surgical procedures should be repeated closely.

A severe ophthalmic burn can also lead to amblyopia in children, which involves a long follow-up of about a year. Amblyopia is the functional decrease in visual acuity in an eye caused by stopping use of that eye during visual development. Severe vision loss can occur in the affected eye if amblyopia is not detected and treated before the age of 8.

What should be done if gel is splashed in the eyes of a child? What should alert parents?

When the eyes are burned by something, the cornea treats the pain by numbing itself. Thus, children cry when they receive the gel in their eyes, but afterwards they no longer have pain, even if they have red eyes. Parents then tend to think that it is not serious, although the burn is there.

If your child receives a large quantity of hydro-alcoholic gel in the eyes, you should consult an ophthalmologist in town as soon as possible or go to the ophthalmic emergency room for a diagnosis. This avoids serious complications (damage to the cornea and iris, perforation of the eye, deformation of the eyelids, Editor’s note)

What should the public authorities do about this problem?

Additional precautions in positioning dispensers in public places, in addition to informative illustrations highlighting the danger of such devices for children, are absolutely necessary to prevent further serious eye damage.

The idea is not to remove this device, essential in the fight against the coronavirus, but to alert parents so that they are more vigilant.