Ocular Damage Due to Chlorhexidine versus Eyeshield Thermal Injury

Abstract

The eyeshields analyzed in this study minimized thermal transfer following a single direct hit with a CO2 resurfacing laser. An understanding of the potential mechanisms of ocular injury is essential in preventing its occurrence.

Ocular Complications After Laser or Light-Based Therapy—Dangers Dermatologists Should Know

“…Of those reporting what procedure was completed resulting in ocular injury, the most common was laser resurfacing (periocular or full facial), followed by epilation (eyebrow, eyelash, facial, or forearm), treatment of pigmented or vascular lesions, and removal of benign tumors of the eyelid (Figure 1). 11–46 Seven cases reported accidental discharge of the laser either during alignment, the procedure, or after procedure completion 12,15,21,31,38,40 ; one case was secondary to improper use of an at-home laser system for epilation, in which the patient looked directly at the laser beam without eye protection. 12…”

Thermal eye injuries from dermatologic laser treatments—an experimental study

“…Several cases reported on the usage of chlorhexidine as an antiseptic agent for eye shields in some practices. This malpractice may result in corneal defects of various degrees ranging from corneal edema, stromal scarring to endothelial destruction when not removed properly before insertion under the eyelid [ 6 , 7 , 19 , 20 ]. In one report, a patient experienced corneal irritation by the eye shield itself [ 21 ].…”

“…Photodisruptive (photomechanical) and photocoagulative (photothermal) effects are the two main mechanisms of damage from dermatologic laser treatments near the eye (Table 1 ). Few cases also reported on physical–mechanical irritation by the eye shield itself and chemical irritation by antiseptic solutions [ 6 , 7 ]. Thermal conduction by the metal eye shields and subsequent thermal injuries have been discussed especially in current literature [ 1 ].…”

Perioperative Corneal Abrasion: Updated Guidelines for Prevention and Management

“…Eye shields are commonly used during periorbital surgery to protect the eye from direct trauma; however, these must be inspected for surface irregularities before each case and require careful placement/removal, as they have been known to cause corneal injury. 19,20 The most important risk factor for perioperative corneal abrasion is lagophthalmos. Although only 5 percent of individuals demonstrate lagophthalmos during normal sleep, 21 the prevalence may be as high as 60 percent in those under general anesthesia.…”