Preventing and Managing Corneal Abrasions as a Complication of Anesthesia

I 1 F ew things are more surprising to patients than waking from non-ocular surgery with sudden eye pain, yet this quiet complication is far more common than most expect.Corneal abrasion is the most common cause of postoperative visual complaints associated with non-ocular surgery performed under anesthesia. 1 While usually minor, this complication can cause significant discomfort, pain, blurred vision, tearing, and redness in the eye.This complication could also be alarming to patients who wake up from a procedure with unexpected symptoms in their eye.In addition to patient safety concerns, corneal abrasion as a complication of anesthesia can lead to increased cost due to additional medications, 2 consultations, increased length of stay, 3 and medical malpractice claims and settlements.4 The cornea is one of the most densely innervated tissues in the body, so even a small, superficial injury can be quite painful.Fortunately, most abrasions that result from anesthesia are minor and heal within 48-72 hours without long-term complications. 1 During general anesthesia, the eyelids may not close completely; protective blink and tearing reflexes are suppressed; and the eyes can be exposed to friction from surgical drapes, masks, or inadvertent contact by staff.1,5 Longer procedures, prone or lateral positioning, and preexisting dry eye disease can increase patients' risk of corneal abrasions while under anesthesia.