Since the introduction of preventive measures the frequency of corneal abrasions during general anesthesia for nonocular surgery has decreased. However, it can still occur if precautions are not taken.
Corneal damage is more likely to happen if:
(1) the eye becomes dry
(2) there is incomplete closure of the eyelids before, during or after the procedure
The most important risk factor for corneal injury is a failure to carefully follow protocol for corneal protection (eyelid closure, eye patch, aqueous gel, careful observation).
Other risk factors for corneal abrasion may include:
(1) longer general anesthesia
(2) inexperienced provider starting the case (student nurse anesthetist)
(3) ASA physical status 1 or 2 (versus 3 or 4)
(4) exophthalmos, lagopthalmos, or other problem with eyelid closure
(5) lapses in the immediate recovery period
The rate of corneal injury can be reduced:
(1) by emphasizing the importance of eye protection
(2) by making sure that eye protection is carefully documented
(3) by investigating all episodes of corneal injury during general anesthesia
