Management of Blood Exposure to the Eye
Blood exposure to the eye should be managed as a potential mucous-membrane exposure with immediate irrigation, exposure reporting, and rapid risk assessment for HIV and viral hepatitis prophylaxis. (archive.cdc.gov)
Immediate First Aid
- Contact lenses should be removed immediately. (archive.cdc.gov)
- Exposed eyes should be flushed at an eye-wash station for 15 minutes if available. (archive.cdc.gov)
- If an eye-wash station is unavailable, eyes should be flushed with 500 mL lactated ringers or normal saline. (archive.cdc.gov)
- If the above is not possible, contaminated eyes should be flushed under a sink with water, preferably tepid, for 15 minutes or as tolerated. (archive.cdc.gov)
- Eyes should be kept open during flushing, with eyeball rotation in all directions to facilitate decontamination. (archive.cdc.gov)
- Medical evaluation should be sought immediately after initial decontamination. (archive.cdc.gov)
Exposure Risk Assessment for Bloodborne Pathogens
- Exposure should be categorized as mucous-membrane exposure when blood contacts the conjunctiva/eye. (cdc.gov)
- The source patient’s HIV, HBV, and HCV status should be obtained when feasible because prophylaxis decisions depend on source infectivity and the exposed person’s immunity status. (cdc.gov)
- PEP decisions for HIV should be time-sensitive because HIV infection can establish quickly after exposure. (cdc.gov)
HIV Post-Exposure Prophylaxis
- HIV PEP should be initiated when care is sought within ≤72 hours after exposure. (cdc.gov)
- HIV PEP is considered for exposures in which an eye mucous-membrane exposure contacts body fluids from a person with HIV within the prior 72 hours. (cdc.gov)
- HIV PEP is not recommended when exposure was >72 hours before evaluation. (cdc.gov)
- PEP initiation should occur as soon as possible because decreasing PEP efficacy is associated with longer time to initiation. (cdc.gov)
- HIV PEP prescribing should follow CDC guidance for recommended antiretroviral regimens based on exposure risk. (cdc.gov)
Hepatitis B Post-Exposure Management
- HBV PEP should be provided for susceptible persons exposed to HBV-containing blood or body fluids. (cdc.gov)
- HBV post-exposure prophylaxis should include hepatitis B vaccine and HBIG for persons who are not fully vaccinated or who have not demonstrated post-vaccination immunity. (cdc.gov)
- Passive HBV prophylaxis should use HBIG at 0.06 mL/kg body weight. (cdc.gov)
Hepatitis C Post-Exposure Management
- Post-exposure prophylaxis for hepatitis C is not recommended for health care personnel with occupational exposure to blood and other body fluids. (cdc.gov)
- Baseline testing for exposed health care personnel should include anti-HCV with reflex to HCV RNA if anti-HCV is positive, preferably within 48 hours after exposure. (cdc.gov)
- If follow-up testing is indicated, HCV RNA should be tested at 3–6 weeks post-exposure. (cdc.gov)
- If HCV RNA is negative at 3–6 weeks post-exposure, a final anti-HCV test is recommended at 4–6 months post-exposure. (cdc.gov)
Follow-Up Care and Safety Monitoring
- Exposed persons should receive follow-up evaluation for prophylaxis toxicity when HIV PEP is initiated. (archive.cdc.gov)
- Follow-up testing should be performed according to the exposure pathogen and source patient status for HIV and viral hepatitis outcomes. (archive.cdc.gov)
Common Pitfalls to Avoid
- Delayed care should be avoided because HIV PEP should be started within 72 hours and is not recommended when exposure is >72 hours before evaluation. (cdc.gov)
- Inadequate decontamination should be avoided because flushing duration and technique are specified for mucous-membrane exposures. (archive.cdc.gov)
- Unnecessary hepatitis C prophylaxis should be avoided because hepatitis C PEP is not recommended for occupational exposures. (cdc.gov)