{"id":93698,"date":"2022-11-21T13:07:43","date_gmt":"2022-11-21T19:07:43","guid":{"rendered":"https:\/\/www.unmc.edu\/newsroom\/?p=93698"},"modified":"2026-01-28T09:35:44","modified_gmt":"2026-01-28T15:35:44","slug":"preventing-corneal-abrasions-more-than-dont-rub-your-eyes","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/newsroom\/2022\/11\/21\/preventing-corneal-abrasions-more-than-dont-rub-your-eyes\/","title":{"rendered":"Preventing Corneal Abrasions: More Than &#8220;Don&#8217;t Rub Your Eyes&#8221;"},"content":{"rendered":"<div class=\"panel body-content\"><div class=\"panel__container\">\n<h2 class=\"wp-block-heading\"><strong>Situation:<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Corneal abrasions, although infrequent (0.03-0.17 percent of cases), continue to occur<\/li>\n\n\n\n<li>Distressing to patients and the most common ocular injury in the perioperative period<\/li>\n\n\n\n<li>Mechanically ventilated ICU patients are also at risk, with an incidence as high as 60 percent<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Background:&nbsp;<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Due to disruption in corneal epithelium<\/li>\n\n\n\n<li>Contributing mechanisms include:\n<ul class=\"wp-block-list\">\n<li>Lagophthalmos<\/li>\n\n\n\n<li>Loss of Bell\u2019s phenomenon and blink reflex<\/li>\n\n\n\n<li>Natural pain responses blunted with analgesia and anesthesia<\/li>\n\n\n\n<li>Decrease in tear production<\/li>\n\n\n\n<li>Desiccation from oxygen<\/li>\n\n\n\n<li>Foreign matter in eye<\/li>\n\n\n\n<li>Trauma from face masks, dangling id badges, linens, patient rubbing eyes, inadvertent pressure, chemicals (prep solution), etc.<\/li>\n\n\n\n<li>Prone position<\/li>\n\n\n\n<li>Prolonged surgery<\/li>\n\n\n\n<li>Inadequate eye protection<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Assessment:<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Common signs and symptoms include unilateral eye pain, scleral injection\/erythema, photophobia, sensation of foreign body, discomfort aggravated by blinking<\/li>\n\n\n\n<li>If minor, prognosis is usually excellent<\/li>\n\n\n\n<li>Larger abrasions can lead to visual disturbances, corneal scarring, blindness<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Recommendations:<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Prevention!\n<ul class=\"wp-block-list\">\n<li>Review of patient eye problems prior to surgery<\/li>\n\n\n\n<li>Removal of contact lenses and eye makeup pre-operatively<\/li>\n\n\n\n<li>Eyes closed and securely taped immediately after induction of anesthesia\n<ul class=\"wp-block-list\">\n<li>Tape horizontally<\/li>\n\n\n\n<li>Occlusive, transparent dressings (such as Tegaderm) are a good option for long procedures<\/li>\n\n\n\n<li>Ophthalmic lubricant use remains controversial<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Check eyes frequently to make sure they are staying taped and closed<\/li>\n\n\n\n<li>Remove eye tape carefully; adhesive can abrade the eyelid<\/li>\n\n\n\n<li>Place pulse oximeter probe on ring or little finger of the non-dominant hand to decrease inadvertent eye contact should patient rub eyes on emergence<\/li>\n\n\n\n<li>Awareness and protection of eyes during MAC cases and with any oxygen use, including ICU patients<\/li>\n\n\n\n<li>\u201cDon\u2019t rub your eyes\u201d patient reminders following emergence from anesthesia<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Occurrence \u2013> prompt treatment that may include Ophthalmology consult\/referral\n<ul class=\"wp-block-list\">\n<li>Utilize \u201cCorneal Abrasion Management Protocol\u201d \u2013 posted in PACUs<\/li>\n\n\n\n<li>Utilize \u201cCorneal Abrasion Order Set\u201d<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">References:<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Palte, HD. Revisiting Perioperative Corneal Abrasion.\u00a0<em>ASA Monitor<\/em>\u00a02018; 82:22\u201325<\/li>\n\n\n\n<li>Corneal abrasion perioperative. In: UpToDate, Post TW, ed. <em>UpToDate<\/em>.\u00a0 UpToDate;2022<\/li>\n\n\n\n<li>Papp AM, Justin GA, Vernau CT, Aden JK, Fitzgerald BM, Kraus GP, Legault GL. Perioperative Corneal Abrasions After Nonocular Surgery: A Systematic Review. Cornea. 2019 Jul;38(7):927-932. doi: 10.1097\/ICO.0000000000001972. PMID: 31033698.<\/li>\n<\/ul>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Situation: Background:&nbsp; Assessment: Recommendations: References:<\/p>\n","protected":false},"author":136,"featured_media":93699,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"18675,67578,91796,45935,53293,38354","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-93698","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO 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