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Corneal abrasions under GA (Perioperative eye injuries are rare but…
Corneal abrasions under GA
Perioperative eye injuries are rare but important complications of anaesthesia. Corneal abrasion most common
Risk factors
Prolonged surgery
Lateral or prone
Operations on head and neck
Causes
Keratopathy
Chemical injury
Direct trauma
GA effects
Reduced tonic contraction of orbicularis oculi (inability to close eye lids)
Inhibits protective bell's phenomenon in which eye turns up in sleep to protect cornea
Decreases tear production
Decreased tear-film stability
Chemical exposure
Cleaning material or antiseptics
Only preservative free providone-iodine 10% in aqueous solution safe
Trauma can occur at any stage from equipment, personelle or patient and can occur pre / intra / post op
Diagnosis
History of trauma
Painful
Confirmed with cobalt-blue filtered light and flourescin
Prevention
Avoid 'dangling' objects (lanyards, stethoscopes)
Care with face mask
Avoid trauma from equipment, surgeon, anaesthetist or semi conscious patient
Eye occlusion +/- ointment
Prognosis
Usually excellent
Avoid patching
Usually do not require treatment unless become infected
Avoid wearing contact lenses