Users Online: 2692 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
Home | About us | Editorial board | Search | Ahead of print | Current issue | Archives | Submit article | Instructions | Subscribe | Contacts | Login 


RSACP wishes to inform that it shall be discontinuing the dispatch of print copy of JOACP to it's Life members. The print copy of JOACP will be posted only to those life members who send us a written confirmation for continuation of print copy.
Kindly email your affirmation for print copies to dranjugrewal@gmail.com preferably by 30th June 2019.

 

 
Table of Contents
LETTER TO EDITOR
Year : 2012  |  Volume : 28  |  Issue : 2  |  Page : 279

Comprehensive eye care : A simple step toward a better outcome


Department of Anesthesiology & Intensive Care Ex Senior Resident, Dr RML Hospital & PGIMER, New Delhi, India

Date of Web Publication11-Apr-2012

Correspondence Address:
Uma Hariharan
House No. B.H. - 41, East Shalimar Bagh, Delhi - 88
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9185.94934

Rights and Permissions

How to cite this article:
Hariharan U. Comprehensive eye care : A simple step toward a better outcome. J Anaesthesiol Clin Pharmacol 2012;28:279

How to cite this URL:
Hariharan U. Comprehensive eye care : A simple step toward a better outcome. J Anaesthesiol Clin Pharmacol [serial online] 2012 [cited 2020 Apr 9];28:279. Available from: http://www.joacp.org/text.asp?2012/28/2/279/94934

Sir,

Eye injuries in the perioperative period have serious implications. The incidence of perioperative visual loss following ocular surgery appears to be much lower than that seen following nonocular surgery. [1] Important ocular injuries include corneal abrasion (most common), conjuctival chemosis, periorbital edema, pressure injury to supplying nerves, proptosis, burn injuries, etc. Patient positioning, especially prone and lateral positions, [2] surgical factors (massive blood loss, prolonged duration, spine or cardiac surgery), [3] pressure by surgeon's hand, coexisting diseases (e.g., anemia, diabetes mellitus, and arteriosclerosis), and pre-existing ocular problems of the patient can cause them. Injury to eyes also includes damage to eyelids, eye lashes, canthi, and eye brows and these structures need to be taken care of in the perioperative period. Proper randomized controlled trials to evaluate such injuries are lacking.

Usually, eyes are covered or padded after securing the airway (during general anesthesia), but before surgical positioning. Pressure injury to eye from face masks may occur. [4] Injury to lashes and eye-lids from hands/elbow/nails as well as laryngoscope handle or Magill's forceps or even taping material can occur.

I prefer covering of the eyes soon after induction and loss of eye lash reflex, before even keeping the mask on the patients face. Such a simple step can minimize injury to these sensitive structures. I adopted this method, after a patient (an upcoming female model) reported postoperatively about her loss of a few eyelashes in her right eye, leading to cancellation of a modeling contract for eye care beauty products. She had undergone a nonocular surgery under general anesthesia. Acceptance of this simple practice requires educating the operating room assistants as well to prepare for eye protection.

 
  References Top

1.Berg KT, Harrison AR, Lee MS. Perioperative visual loss in ocular and nonocular surgery. Clin Ophthalmol 2010;24:531-46.  Back to cited text no. 1
    
2.Cheng MA, Todorov A, Tempelhoff R, McHugh T, Crowder CM, Lauryssen C. The effect of prone positioning on intraocular pressure in anesthetized patients. Anesthesiology 2001;95:1351-5.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.Lee LA, Roth S, Posner KL, Cheney FW, Caplan RA, Newman NJ, et al. The American Society of Anesthesiologists Postoperative Visual Loss Registry: Analysis of 93 spine surgery cases with postoperative visual loss. Anesthesiology 2006;105:652-9.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4.Durkan W, Fleming N. Potential eye damage from reusable masks. Anesthesiology 1987;67:444.  Back to cited text no. 4
[PUBMED]  [FULLTEXT]  



This article has been cited by
1 Eye Care- Modification in Standard Practice
Preety M Roy
British Journal of Anaesthesia. 2016; 117: el_13690
[Pubmed] | [DOI]
2 Perioperative eye protection under general anesthesia
Prakash, S.
Journal of Anaesthesiology Clinical Pharmacology. 2013; 29(1): 138-139
[Pubmed]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
   References

 Article Access Statistics
    Viewed1484    
    Printed60    
    Emailed1    
    PDF Downloaded317    
    Comments [Add]    
    Cited by others 2    

Recommend this journal