Patient Benefits

Why is Eyelid Occlusion Necessary during General Anaesthesia?

Exposure keratitis

A corneal abrasion can turn into a corneal ulcer (ulcerative keratitis) if proper treatment is not commenced within 18 hours

59% of people under general anaesthesia experience lagopththalmos, or incomplete eye closure. As a consequence, they can suffer from exposure keratitis, a condition in which the cornea dries out.

The symptoms the patient may experience include pain and irritation, foreign body sensation, tearing and photophobia.

In addition, exposure keratitis can allow the cornea to attach to the inside of the eyelid, causing a corneal abrasion when the eyelid moves.

Corneal abrasions in theatre can also result from direct trauma from items such as drapes, face masks, surgical instruments and anaesthetic circuits.

Many cleaning solutions such as Betadine, chlorhexidine and alcohol may be very harmful to the eyes. When preparing for surgery, especially on the face, neck or shoulder, droplets may enter the eye causing chemical injury.

Issues with Current Methods

Current methods of protecting the eyes do not provide total protection.

Tape being removed from eye post-procedure

Opthalmic ointments do not protect against direct trauma or chemical exposure, and can have side effects such as blurred vision and irritation.

Tape may not provide or maintain complete eye closure, therefore insufficient moisture is retained in the eye. It can also contribute to trauma upon removal such as ulceration or bruising of the eyelid or eyelash removal.

Research shows that as many as 51% of partly used rolls of tape test positive for MRSA and/or VRE. With a growing rate of hospital acquired infections and antibiotic resistant bacteria, eliminating such a risk is an essential part of prevention.

 

Read the research behind this page:

  1. Wilson, SA & Last, A 2004, 'Management of Corneal Abrasions',American Family Physician, vol. 70, no. 1, pp. 123-128 Read Article
  2. Priya N Nair & Emert White 2014, 'Care of the Eye During Anaesthesia and Intensive Care', Anaesthesia and Intensive Care Medicine, vol. 15, no. 1, pp. 40-43, Read Article
  3. Marcucci, C, Cohen, NA, Metro, DG & Kirsch, JR 2008, Avoiding Common Anesthesia Errors, Lippincott Williams & Wilkins, Philadelphia PA USA Read Book
  4. Harris, PNA, Ashhurst-Smith, C, Berenger, SJ, Shoobert, A & Ferguson, JK 2012, 'Adhesive Tape in the Health Care Setting: Another High-Risk Fomite?', The Medical Journal of Australia, vol. 196, no. 1, p. 34, Read Article

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