Eye protection in anaesthesia and intensive care

Checking the integrity of eyes in prone position: A novel application of video laryngoscopes

“…Chui and Craen 10 in their update on prone positioning recommend checks every 30 min without clear evidence. The French Society for Anesthesia and Intensive Care (SFAR) states in her expert opinion that “It is probably recommended that absence of any extrinsic compression of the eyeball during the procedure be checked.” 11 In our case, the video laryngoscope proved to be a simple but effective (and efficient) tool for checking proper guarding of the patient’s eyes directly after a change to prone position as well as during regular checks thereafter. In connection with a digital patient information system, the resulting images might even be stored for medico-legal documentation.…”

“…Most of the following recommendations are based on case reports and expert opinion. 8 – 11 Authors agree on the benefit of avoiding hypotension, and suggest invasive blood pressure monitoring especially in high-risk cases. There is no agreement on a transfusion threshold, but periodic monitoring of hematocrit is suggested.…”

The Conjunctival Turnover: A Simple and Effective Method for Sclero-Corneal Protection in Pre-Septal Transconjunctival Approach to the Orbital Floor

“…Physical causes include changes in temperature and air within the operation theatre which inflict indirect trauma to cornea [4]. Mechanical reasons may be inadvertent direct trauma due to instruments or undue pressure exerted on the globe [5]. Chemical injury is commonly due to anti-microbial agents [6].…”

Anesthesia and Eye Diseases: Comment

“…Somewhat surprisingly, advocates of eyelid closure immediately after loss of eyelid reflex rule out this approach in cases of rapid sequence induction, arguing that securing the airway takes precedence over eye protection. 4,7,10,12 However, the risk of traumatic corneal injuries is likely greater during rapid sequence induction compared to standard induction of anesthesia because the emphasis on rapid endotracheal intubation (and, possibly, on application of cricoid pressure) distracts from attention to effective eye protection. Should endotracheal intubation fail during rapid sequence induction, it is not all that uncommon that subsequent airway management becomes somewhat uncoordinated and will now take place in the absence of any eye protection.…”