To the Editor

The article in the Fall 1998 Newsletter regarding eye care for patients receiving general anesthesia did not address the issue of protection against a chemical conjunctivitis which could arise intraoperatively. The potential sources of chemical irritation to the eye include blood, prep solution (Betadine solution 10% is diluted to a 5% solution for opthalmalogic use), irrigation solution, benzoin, mastisol, and vomitus. This concern has been the basis for the method which I use to provide eye care for my patients, in which I passively close the eyelid, then completely cover and seal shut the eye with a length of 1″ tape, with the tape margins extending well beyond the margins of the inner and outer canthus. I feel the method of taping the eye that was pictured in the newsletter does not provide adequate protection from these potentially noxious solutions entering the eye. I have not as yet had a patient who has experienced a chemical conjunctivitis, but I have observed several “close calls,” which were (surprisingly) not limited to operative procedures involving the head and face. I also wish to point out that I try to perform eye care as soon after induction of anesthesia as possible, to avoid any mechanical damage which could arise from the face mask, or from activities during the process of intubation or laryngeal mask placement.

Geraldine Syverud, CRNA
University of Virginia
Charlottesville, VA