Nail glue is a cyanoacrylate adhesive, commonly known as super glue. Accidental contact with the eye, often from mistaking the small bottle for eye drops, is a serious emergency requiring immediate action. This substance is designed for rapid bonding, making its presence near delicate ocular structures a significant concern. Understanding the chemical reaction and the necessary immediate response minimizes potential damage.
How Cyanoacrylate Interacts with Eye Tissue
Cyanoacrylate monomers react instantly upon contact with moisture, which is abundant in the eye through tears. This contact initiates anionic polymerization, rapidly converting the liquid adhesive into a hard, solid plastic polymer. This instantaneous hardening causes the eyelids or eyelashes to stick together, a condition known as pseudotarsorrhaphy.
During this rapid change, an exothermic reaction occurs, releasing a small amount of heat. This heat can cause minor irritation or a superficial thermal burn on the surface tissues. The glue can bond to the skin of the eyelids, the conjunctiva (the clear membrane covering the white of the eye), or directly to the corneal surface. Injury severity depends on the volume of glue and the specific area of contact.
Immediate First Aid Procedures
The first step is to remain calm and avoid the instinctive reaction to rub the eye. Forcefully attempting to separate adhered eyelids can cause mechanical trauma, potentially tearing the skin or abrading the cornea. The immediate action is to begin continuous, gentle flushing of the affected eye with lukewarm tap water or a sterile saline solution.
The eye should be irrigated for 15 to 20 minutes to continuously wash away unpolymerized glue and loosen the hardened adhesive. If the eyelids are stuck shut, do not attempt to pry them open; continue flushing over the closed lid. This continuous moisture application softens the glue and prevents further bonding. After flushing, you must seek professional medical attention immediately, even if the eye feels improved.
Professional Medical Removal and Assessment
Upon arrival at an emergency department or eye care specialist, the assessment begins with an examination of the eye structure and visual acuity. The physician uses a specialized microscope called a slit lamp to inspect the cornea and conjunctiva for microscopic damage. Fluorescein dye, an orange stain that glows under blue light, is used to highlight areas of epithelial damage, such as a corneal abrasion.
If the eyelids are adhered, professional removal focuses on gentle separation without causing further tissue damage. The medical team may apply sterile saline, mineral oil, or a petroleum-based antibiotic ointment for several minutes to loosen the glue bond. The adhesive is then mechanically removed using fine instruments, such as forceps or a specialized blunt muscle hook, often requiring the careful trimming of glued eyelashes. Following removal, the patient is prescribed topical antibiotic drops or ointment to prevent secondary infection and promote the healing of superficial injuries.
Expected Recovery and Long-Term Prognosis
The outlook for most accidental nail glue exposures is favorable, with a high probability of complete recovery. If the adhesive affected only the eyelids or superficial conjunctival tissue, swelling and redness usually resolve quickly within a few days. The natural shedding of epithelial cells on the skin and conjunctiva assists in the spontaneous detachment of any remaining small glue fragments.
If the cornea sustained an abrasion where the glue adhered directly, the injury can be painful, but the corneal epithelium heals remarkably fast. Permanent vision impairment or scarring is a rare outcome, generally occurring only if there was a significant chemical burn or if a secondary infection developed. Prompt medical attention significantly decreases the risk of these more serious complications.