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PurposeMethodsResultsConclusion\nKey SummariesThe purpose of this study is to evaluate the epidemiological trends, primary ocular diagnosis, and degree of injury severity in pediatric patients after a toy-related ocular trauma.A cross-sectional analysis was conducted using data from the National Electronic Injury Surveillance System Study (NEISS), encompassing patients who visited emergency departments over a 5-year period from January 1, 2017, to December 31, 2021, with toy-related ocular injuries. Descriptive statistics were employed using Microsoft Excel.Among the 1439 toy-related ocular injuries identified, the mean age of injury was 6.67 ± 4.36 years. The highest proportion of injuries occurred in the 2–5 years age group (27.2%). The NEISS database classified the severity of injury – the majority of which were minor anterior segment injuries. Toy guns with projectiles were identified as the most common type of toy associated with ocular eye injury. While most injuries were minor, a small percentage was severe.Age-appropriate toy selection and adult supervision during playtime are recommended preventive measures to mitigate the incidence and severity of traumatic eye injuries in children. There is a risk of major ocular injury related to toys, especially toy guns/darts, in young children that requires intervention.However, the incidence of injuries related to toy guns has been stable for the last 40 years.Although most of these cases resulted in minor anterior segment injuries, patterns of serious injury can occur with toys.Physicians, educators, and parents should be made aware of the high risk of ocular toy-related injury when there is poor supervision, inadequate ocular protection, and a lack of understanding of toy-related risks to the eye.There is a risk of major ocular injury related to toys, especially toy guns/darts, in young children that requires intervention.However, the incidence of injuries related to toy guns has been stable for the last 40 years.Although most of these cases resulted in minor anterior segment injuries, patterns of serious injury can occur with toys.Physicians, educators, and parents should be made aware of the high risk of ocular toy-related injury when there is poor supervision, inadequate ocular protection, and a lack of understanding of toy-related risks to the eye. [ABSTRACT FROM AUTHOR]

This study aims to review ophthalmic injuries sustained during of robotic-assisted laparoscopic prostatectomy (RALP). A search of Medline, Embase, Cochrane and grey literature was performed using methods registered a priori. Eligible studies were published 01/01/2010–01/05/2023 in English and reported ophthalmic complications in cohorts of > 100 men undergoing RALP. The primary outcome was injury incidence. Secondary outcomes were type and permanency of ophthalmic complications, treatments, risk factors and preventative measures. Nine eligible studies were identified, representing 100,872 men. Six studies reported rates of corneal abrasion and were adequately homogenous for meta-analysis, with a weighted pooled rate of 5 injuries per 1000 procedures (95% confidence interval 3–7). Three studies each reported different outcomes of xerophthalmia, retinal vascular occlusion, and ophthalmic complications unspecified in 8, 5 and 2 men per 1000 procedures respectively. Amongst identified studies, there were no reports of permanent ophthalmic complications. Injury management was poorly reported. No significant risk factors were reported, while one study found African-American ethnicity protective against corneal abrasion (0.4 vs. 3.9 per 1000). Variables proposed (but not proven) to increase risk for corneal abrasion included steep Trendelenburg position, high pneumoperitoneum pressure, prolonged operative time and surgical inexperience. Compared with standard of care, occlusive eyelid dressings (23 vs. 0 per 1000) and foam goggles (20 vs. 1.3 per 1000) were found to reduce rates of corneal abrasion. RALP carries low rates of ophthalmic injury. Urologists should counsel the patient regarding this potential complication and pro-actively implement preventative strategies. [ABSTRACT FROM AUTHOR]

While the prevailing treatment for corneal abrasions outside the athletic sphere is the application of a bandage contact lens (BCL), which lessens pain and allows for the maintenance of binocular vision, this is not the case during athletic play. This brief report highlights the advantage of BCLs in treating in-game corneal abrasions, ultimately allowing for an immediate return to play. Additionally, this report summarizes the mechanisms of bandage contact lenses, differentiates them from standard hydrogel contact lenses, and highlights the significant steps necessary to apply the bandage contact lens during an in-game corneal abrasion event. Overall, we link modern ophthalmology clinical practice and sports medicine, allowing for the attenuation of acutely-induced ocular pain to a manageable state.

To study the efficacy of 100% Leptospermum medical grade Manuka honey ointment in persistent corneal epithelial defects (CEDs). Case series. Case 1 was a 25-year-old female patient who presented to the cornea clinic with a persistent CED (3.5 mm), following acanthamoeba keratitis, that had failed to respond to heavy, frequent lubrication drops and ointment. Two weeks later, after starting Leptospermum honey ointment (4 times per day), the CED healed totally. Case 2 was a 48-year diabatic, single-eyed female patient who presented with a persistent CED (1.5 × 1.5 mm) that had failed to respond to heavy, frequent lubrication drops and ointment. The CED healed three weeks after starting Leptospermum honey ointment (4 times per day). Leptospermum honey ointment can be a potential treatment for persistent epithelial defect. [ABSTRACT FROM AUTHOR]

Introduction: Vision loss is an ophthalmologic emergency with broad differential requiring prompt medical attention.Case Report: We describe a 55-year-old male presenting to the emergency department (ED) with unilateral, painless visual field deficit with ipsilateral conjunctivitis induced by a presumed foreign body. The patient described a foreign body sensation nine days prior to developing visual changes. In the ED, the patient was diagnosed with a retinal detachment using point-of-care ultrasonography, and emergent ophthalmologic consultation was obtained.Conclusion: Concurrent retinal detachment and conjunctivitis in a patient is extremely rare. Healthcare providers should be aware that foreign body-induced conjunctivitis could lead to retinal detachment.

This article describes care of the eye through a period of potential vulnerability, during patient management under general anaesthesia and in the intensive care unit. Risk factors, mechanisms of injury, recognition and management of common and important eye injuries are covered, as well as good practice points and preventative measures pertinent to all anaesthetists and intensive care staff. [ABSTRACT FROM AUTHOR]

Topical anesthetics for control of pain from corneal abrasions can cause drug-related toxicity that delays corneal healing. This report documents three cases where topical anesthetic drops were prescribed in the emergency department for pain control, after which patients developed persistent ocular pain, epithelial toxicity with impaired healing, and significant loss of vision. On consultation with the ophthalmology service, each patient was instructed to discontinue the topical anesthetic drops but to continue topical antibiotics. Soon thereafter, symptoms resolved, and the corneas healed within 72 hours. This report emphasizes the harm that can result from injudicious and/or unmonitored use of topical anesthetics for corneal abrasions. We advise emergency medicine and primary care providers against providing topical anesthetics to patients with corneal abrasions., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Mayo Clinic Institutional Review Board issued approval 24-004713. This retrospective study was performed in accordance with the tenets of the Declaration of Helsinki and was approved by the Mayo Clinic IRB on April 29, 2024. The study was determined to be of low risk to the subjects. There is no personal identifying information within this work. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Miller et al.)

Summary: Background: In low-and-middle income countries, corneal abrasions and ulcers are common and not always well managed. Previous studies showed better clinical outcomes with early presentation and treatment of minor abrasions, however, there have been no formal studies estimating the financial impact of early treatment of abrasions and ulcers compared to delayed treatment. Methods: We used the LV Prasad Eye Institute's (LVPEI's) electronic health record system (eyeSmart) to estimate the impact of early presentation on clinical outcomes associated with abrasions and ulcers. 861 patients with corneal abrasion and 1821 patients with corneal ulcers were studied retrospectively, and 134 patients with corneal abrasion prospectively. A health economic model was constructed based on LVPEI cost data for a range of patient scenarios (from early presentation with abrasion to late presentation with ulcer). Findings: Our findings suggest that delayed presentation of corneal abrasion results in poor clinical and economic outcomes due to increased risk of ulceration requiring more extensive surgical management, increasing associated costs to patients and the healthcare system. However, excellent results at low cost can be achieved by treatment of patients with early presentation of abrasions at village level health care centres. Interpretation: Treatment of early minor corneal abrasions, particularly using local delivery of treatment, is effective clinically and economically. Future investment in making patients aware of the need to react promptly to corneal abrasions by accessing local healthcare resources (coupled with a campaign to prevent ulcerations occurring) will continue to improve clinical outcomes for patients at low cost and avoid complex and more expensive treatment to preserve sight. Funding: This research was funded by the Medical Research Council, grant MR/S004688/1.

This evidence-based practice change project examined the use of supine positioning as a substitute for lateral positioning after sedation for endoscopic procedures for the purpose of preventing corneal injuries in this patient population. This study used a pre and post implementation design. Retrospective data was collected over 12 months, including 4,422 endoscopic procedures for comparison to the prospective data collected after implementing the practice change, which totaled eight months and 3080 procedures. Incidence rates for corneal injury and eye irritation were 0.158% before the practice change, with a decrease in incidence to 0.097% after the change. Using a two-sided Fisher's exact test, the results were not statistically significant (P =>.05). Additionally, linear regression showed a slight downward trend with implementation; however, these results were also not statistically significant. The intervention did not have a statistically significant impact on the incidence of corneal injury. It is possible that more than one risk factor was contributing to corneal injury in this setting and the intervention only addressed one potential risk factor. [ABSTRACT FROM AUTHOR]

We assessed our institution's rate of perioperative and periprocedural corneal abrasions (CAs) and implemented a quality improvement project to improve our detection of CAs and decrease their incidence by at least 25% over 12 months. Retrospective review before and after initiation of a quality improvement project at a single tertiary care institution We retrospectively reviewed surgical and procedural patients requiring any type of anesthesia care over three 1-year time periods (2014-2015, 2016-2017, and 2017-2018). Using an electronic pharmacy-based query to identify patients who received proparacaine eye drops in the recovery room, we were able to estimate our incidence of CA during these time periods. We implemented a best practice plan to standardize CA prevention, diagnosis, and treatment after determining our baseline incidence of CA. Our baseline incidence rate of perioperative and periprocedural CAs was 0.22% (43/19,790 anesthetics) in the 2014-2015 time period. In the 2016-2017 and 2017-2018 time periods, the incidence rate was reduced to 0.09% (21/23,652 anesthetics) and 0.1% (23/23,825 anesthetics), respectively. The use of a standardized CA prevention, diagnosis, and treatment plan reduced the relative risk of CAs by 59% in 2016-2017 (P <.001) and 56% in 2017-2018 (P =.001) compared to baseline, with an absolute reduction of 13% and 12% over those time periods. Our data suggests that the adoption of a simple, standardized perioperative and periprocedural CA prevention, diagnosis, and treatment plan can result in sustained reductions in the occurrence of perioperative CAs. [ABSTRACT FROM AUTHOR]

The importance of protective eyewear during activities which involve high velocity projectiles is often emphasized to patients, however the material and design of such eyewear is also important. We present the case of a boy who sustained ocular injury from a plastic airsoft bullet while wearing a protective mask issued by the manufacturer. The patient was found to have decreased vision, a corneal abrasion and hyphema. The patient fully recovered with topical prednisolone, cyclopentolate, and moxifloxacin. It is important to advocate for using polycarbonate protective eye wear for our patients who are engaging in activities which involve high velocity projectiles.

Background: Despite potential benefit, outpatient use of topical ophthalmic anesthetics can result in poor healing, infection, scar, and blindness. An unbiased analysis of randomized controlled trials (RCTs) is needed to examine their effectiveness and safety compared with placebo or other treatments for corneal abrasions., Methods: Cochrane Central Register of Controlled Trials, MEDLINE, Embase.com, Latin American and Caribbean Health Sciences, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform were searched on February 10, 2023, without restriction on language or publication date., Results: Systematic review and meta-analysis of nine RCTs describing 314 participants with post-traumatic abrasions and 242 participants with post-surgical abrasions, with a median study length of 7 days (interquartile range, 7-14), show no evidence of a difference in pain control between anesthetics and placebo at 24 hours in post-trauma cases. Self-reported pain at 24 hours is reduced with anesthetics plus topical nonsteroid anti-inflammatory drug in post-surgical participants (mean difference [MD], -5.72 on a 10-point scale; 95% CI, -7.35 to -4.09; 1 RCT; 30 participants) and at 48 hours with anesthetics alone in post-trauma participants (MD, -5.68; 95% CI, -6.38 to -4.98; 1 RCT; 111 participants). Anesthetics are associated with 37% increased risk of non-healing defects (risk ratio, 1.37; 95% CI, 0.78 to 2.42; 3 RCTs; 221 post-trauma participants). All evidence is of very low certainty. Over 50% of trials have an overall high risk of bias., Conclusions: Available evidence is insufficient to support outpatient use of topical anesthetics for corneal abrasions with respect to pain, re-epithelialization, and complication risk., Competing Interests: Additional Declarations: There is NO Competing Interest. Conflicts of Interest: No other financial disclosures to report. Competing Interests The authors declare no competing interests.

Introduction: Corneal abrasion (CA) is the most common ocular complication in patients undergoing nonocular surgery. Corneal abrasions can be caused by a variety of mechanisms, the most common being drying of the cornea due to reduced tear secretions, loss of eyelid reflex, and the loss of pain recognition during surgery. Though CA heals well with eye lubricants, it can result in significant ocular pain and some cases may go on to develop ocular complications. With the current switch to outpatient total joint replacement, CA could potentially lead to discharge delays. Materials and Methods: We examined the results of a quality improvement project to reduce CA during general anesthesia to determine the rates of CA during hip and knee total joint replacement. We compared rates of CA for 6 months before and 6 months after the intervention. Results: A total of 670 hip and knee arthroplasty procedures were performed during this period. Two events of CA occurred, one occurred before and one after the intervention to decrease eye injuries. Both incidences occurred during total hip arthroplasty (THA) procedures with the patient in the lateral decubitus position and recovered without long-term deficit. Discussion: Surgeons and anesthesiologists alike should be cognizant of this avoidable complication and take precaution to protect the eyes during surgery, especially during THA when the patient is placed in the lateral decubitus position. Conclusion: Corneal abrasion during total joint arthroplasty is a rare complication and is infrequently addressed in the literature. CA is mostly self-limiting, however, but may lead to patient dissatisfaction and to delays if same-day discharge is attempted. Preventative measures and attentive care may help reduce the incidence of CA in patients undergoing total joint arthroplasty. The lateral decubitus position and longer surgeries times are risk factors for CA. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of the study was to determine knowledge, practice, and resources available to primary care physicians to diagnose and manage corneal abrasion in Saudi Arabia. METHODS: This cross-sectional survey was held in 2017. Family physicians and emergency physicians attending an international conference were surveyed. The questions related to demography, invagination, and tools available in their institute were collected. The questionnaire on how to diagnose and how they manage case of corneal abrasion was also collected using tablet-based software. RESULTS: Two hundred and twenty-five participants participated in the survey. Exposure to eye patients in two-third of participants was too low (93; 39.6%). Resources for diagnosing corneal abrasion were available in limited centers (51; 21.7%). The rate of good practice to manage corneal abrasion was 21.2% (95% confidence interval 16.0; 26.5). Certified emergency physicians (P < 0.001) and western and central regions (P < 0.001) were positively associated with good practice. Availability of slit lamp (P = 0.2) was not significantly associated with the level of practice to manage corneal abrasion. Fluorescein staining and use of cobalt blue light are essential for diagnosing corneal abrasion as per 40% of participants. About 44.7% of participants replied that antibiotics and lubricants should be used to treat. Nearly one-fourth of participants suggested urgent reference to the ophthalmologist. Use of specific antibiotic varied widely; however, ofloxacin was the main choice of antibiotic in treating corneal abrasion. CONCLUSION: The knowledge and practice among physicians about corneal abrasion were low. Integrating primary eye care into emergency services through provision of required resources and training physicians is recommended. [ABSTRACT FROM AUTHOR]

While the prevailing treatment for corneal abrasions outside the athletic sphere is the application of a bandage contact lens (BCL), which lessens pain and allows for the maintenance of binocular vision, this is not the case during athletic play. This brief report highlights the advantage of BCLs in treating in-game corneal abrasions, ultimately allowing for an immediate return to play. Additionally, this report summarizes the mechanisms of bandage contact lenses, differentiates them from standard hydrogel contact lenses, and highlights the significant steps necessary to apply the bandage contact lens during an in-game corneal abrasion event. Overall, we link modern ophthalmology clinical practice and sports medicine, allowing for the attenuation of acutely-induced ocular pain to a manageable state., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Kubba, Kandavel, Scott, Roldan and Jackson.)

Purpose: Many consumer products and non-ophthalmic medications are packaged in plastic “eye dropper” bottles, posing a risk of accidental ocular chemical injury when these substances are mistaken for eye drops. Observations: We present the case of an elderly glaucoma patient who mistook blue stamper ink for the glaucoma medication Combigan®, and suffered ocular injury as a result. Conclusions and importance: The packaging of non-ophthalmic products in plastic “eye dropper” bottles poses a significant risk of accidental ocular chemical injury. Elderly individuals with low vision and/or cognitive deficits may be at particular risk of accidental injury. Ophthalmologists have been calling for a greater distinction between the packaging of ophthalmic and non-ophthalmic products for over 35 years, but to date little progress has been made in this regard.

Purpose: Bee sting injuries to the eye and surrounding tissue are an infrequent occurrence. Here we present an interesting Case of a 64 year old bee keeper who was stung in the left upper eyelid. Observations: After the injury, she developed pain and inflammation of the eyelid though a few days after the injury noted increased eye pain. On initial ophthalmic assessment, no retained foreign body was noted. Six days after the incident, her lid edema had improved and a retained foreign body – the bee stinger - had been found on eversion of the eyelid. We propose that as the inflammation resolved, the stinger extruded from the inner eyelid tissue, causing a corneal abrasion, which was the source of her acute increase in pain. Conclusion and Importance: In cases of bee injuries, it is paramount to consider the possibility of retained foreign bodies and to perform a thorough ophthalmic examination and assessment.

Sotonibi AH Cookey, Ireju O Chukwuka, Ogochukwu A Sibeudu Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria Background: Ocular superglue injury is uncommon all over the world.Aim: To report a case of self-inflicted accidental ocular superglue injury. Methods: A case of ocular injury is described in a 29-year-old adult, following inadvertent instillation of superglue instead of a prescribed steroid ointment into the right eye, in the dark. Results: There was matting of the upper and lower lid margin and eyelashes precluding view of the ocular structures. The eyelids were separated by gently peeling off the superglue from the lids and lid margins. The glue-matted eye lashes were trimmed and the glue on the cornea and conjunctival surface was gently removed. Subsequently, a corneal ulcer was seen which was managed with topical antibiotics, systemic analgesics, and vitamins. Conclusion: Similarity between the tubes of eye ointments and household superglue accounts for the accidental eye injury. Keywords: superglue, ocular injury, sticking of eyelids, corneal abrasion

Purpose: To demonstrate the therapeutic benefit of extended wear bandage contact lens (BCL) use in patients with epidermolysis bullosa (EB) suffering from recurrent, painful, and slow-to-heal corneal epithelial defects.Methods: Case reports of three patients.Results: We report ophthalmic treatment of three pediatric patients, two with recessive dystrophic EB (RDEB) and one with junctional EB (JEB), who suffered frequently recurrent corneal abrasions and were treated with 30-day extended-wear bandage contact lenses (BCLs), replaced every month for at least 1 year. Pain and frequency of corneal abrasions improved immediately, and the BCLs were well tolerated. Vision was maintained or improved in all cases. Corneal ulcers did not occur while on antibiotic prophylaxis.Conclusions: Continuous and prolonged BCL therapy in patients with EB can be an effective way to immediately alleviate pain, prevent recurrent abrasions, and improve patient quality of life. [ABSTRACT FROM AUTHOR]

This article describes care of the eye during a period of vulnerability in anaesthesia and intensive care. Risk factors, mechanisms of injury, recognition and management of common and important eye injuries will be covered as well as good practice points and preventative measures pertinent to all anaesthetists and critical care practitioners. [ABSTRACT FROM AUTHOR]

AIM: To evaluate the outcomes of alcohol delamination (ALD) of the corneal epithelium for the treatment of recurrent corneal erosion syndrome (RCES) and to implement a standardized treatment protocol for this condition utilizing evidence based practice and the findings of an internal audit. METHODS: A retrospective analysis of 42 eyes of 40 patients diagnosed with RCES who were treated with ALD between January 2006 and March 2016 was conducted. Patients had 20% alcohol applied to the cornea with the use of a well for 40s. Patients were reviewed one week later in the Outpatient Department. Outcome criteria were established based on standards from other studies in the medical literature. These included, a treatment success rate of at least 72% (defined as complete resolution of symptoms one month after treatment), a postoperative complication a rate of

Objective This article evaluates the effectiveness of an ophthalmology resident-led quality improvement (QI) initiative to decrease the incidence of perioperative corneal injury at an academic medical center Design Retrospective chart review. Methods A retrospective chart review was conducted of all surgical cases performed 6 months prior to, and 6 months after, implementation of an ophthalmology resident-led QI initiative at an academic medical center. The QI initiative (which focused on perioperative corneal injury awareness, understanding of risk factors, and presentation of an algorithm designed to prevent perioperative corneal injury) consisted of a lecture and distribution of educational materials to anesthesia providers. Data collected through the chart review included type of surgical case, presence of diabetes mellitus or thyroid disease, patient age and gender, patient positioning (supine, prone, or lateral), level of anesthesia provider training, length of surgical case, surgical service, type of anesthesia, and type (if any) of perioperative eye injury. The rates of perioperative corneal injury pre- versus post-initiative were compared. Results The rates of perioperative corneal injury pre- and post-initiative were 3.7 and 1.9 per 1,000, respectively (p = 0.012). Significant risk factors for perioperative corneal injury include longer duration of surgery (odds ratio [OR] 90–180 vs. 180 vs. 180 vs. 90–180 = 2.05, 95% CI 1.17–3.58), patient position lateral > prone > supine (OR prone vs. lateral = 0.25, 95% CI 0.09–0.67; OR supine vs. lateral = 0.13, 95% CI 0.07–0.23), nonhead and neck surgeries (OR = 0.32, 95% CI 0.11–0.87), and surgery performed under the general surgery service (OR general surgery service vs. other subspecialty services = 6.50, 95% CI 2.39–24.76). Conclusions An ophthalmology resident-led QI initiative consisting of educating anesthesia providers was associated with a significant decrease in the rate of perioperative corneal injury.

Background: A corneal abrasion is a flaw in the cornea's epithelial surface, which is located in the front of the eye. It causes recurrent erosions, corneal inflammation, and chronic corneal defects. In a context with limited resources, the goal of this review was to provide an evidence-based procedure for perioperative risk stratification, prevention, and management of corneal abrasion during non-ocular surgery., Methods: A medical search engines of PUBMED, GOOGLE SCHOLAR, COCHRANE REVIEW, and PUBMED CENTERAL to get access for current and updated evidence on procedures on risk stratification, prevention and management of corneal abrasion for non-ocular surgery. The authors formulate the key questions, scope, and articles written in English language, human study focuses on corneal abrasion, articles in the last 20 year was implemented to identify or filter high-level evidences were included. Reports contain corneal abrasion due to ocular surgery were excluded. All the research articles, which were identified from searches of electronic databases, were imported into Endnote software, duplicate were removed advanced search strategy of electronic sources from databases and websites was conducted using Boolean operators (cornea AND (abrasion OR injury OR laceration)) AND ("Perioperative Period" OR "general anesthesia"). Screening of literatures was conducted with proper appraisal checklist. This review was reported in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 statement., Results: From 8767 identified articles, two hundred articles were removed for duplication and 7720 studies were excluded, 1205 articles were retrieved and evaluated for eligibility. Finally, 24 were included in this systematic review. Advanced age, Prominent eyes, exophthalmus, ocular surface abnormalities (dry eye), expected duration of surgery (>1 h), the favourable position of the surgery, prone,Trendelenburg and lateral, risk of bleeding, surgical site of the surgery(head /neck) and diabetes mellitus were risk for corneal abrasion. The use of appropriate intervention with pharmacological and Non-pharmacological strategies minimizes the occurrence of perioperative corneal abrasion was crucial for the quality of care., Conclusion: Preventing and managing corneal abrasion improves patients' quality of life. However, there was insufficient evidence to draw conclusions, and high-quality trials of multimodal interventions matched to risk stratification and prevention of corneal abrasion needed to provide robust evidence to guide prevention and management of perioperative corneal abrasion., Competing Interests: The authors declared that they have no conflicts of interests.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: To comprehensively review the literature regarding recurrent corneal erosion (RCE) and to present treatment options and recommendations for management. Overview: RCE usually presents with sharp, unilateral pain upon awakening, in an eye with an underlying basement membrane dystrophy, prior ocular trauma, stromal dystrophy or degeneration, or prior surgery for refractive errors, cataracts, or corneal transplantation. Making the correct diagnosis requires a careful slit-lamp examination of both eyes coupled with a high degree of suspicion. Several treatments are commonly used for RCE but new therapies have been introduced recently. Conservative treatment consists of antibiotic and preservative-free lubricating drops, with topical cycloplegics and oral analgesics to control pain. Patients who are unresponsive to these therapies may benefit from therapeutic bandage contact lenses (BCL). Newer therapies include oral matrix metalloproteinase (MMP) inhibitors, blood-derived eye drops, amniotic membrane graft application, and judicious application of topical corticosteroids. Once the epithelium is healed, a course of hypertonic saline solution and/or ointment can be used. Surgical procedures may be performed in patients who fail conservative therapy. Punctal occlusion with plugs increases the tear film volume. Epithelial debridement with diamond burr polishing (DBP), anterior stromal puncture (ASP), or alcohol delamination should be considered in selected patients. DBP can be used for patients with basement membrane dystrophies and is the preferred treatment overall due to a low recurrence rate. ASP can be used for erosions outside the central visual axis. Excimer laser phototherapeutic keratectomy is an attractive option in eyes with central RCE since it precisely removes tissue while preserving corneal transparency. In patients with RCE who are also candidates for refractive surgery, photorefractive keratectomy can be considered. Summary: Newly introduced therapies for RCE enable therapy to be individualized and lower the recurrence rate. [ABSTRACT FROM AUTHOR]

Purpose: During shoulder surgery in the beach-chair position, head fixation can sometimes cause rare complications. The authors share their experience in treating ocular injury due to improper head fixation during surgery in the beach-chair position.Methods: The study investigated consecutively 6075 patients who underwent shoulder surgery in the beach-chair position between March 2007 and March 2016, those patients who saw an ophthalmologist with a complaint of post-operative ocular discomfort. In the beach-chair position, surgery is performed with the patient's upper body raised by 70°.Results: A total of seven patients saw an ophthalmologist due to post-operative ocular discomfort, and a total of five patients (0.082%) had corneal abrasion. Three of these patients underwent arthroscopic surgery, and the other two underwent open surgery. The mean surgery duration for the five patients was 45.0 ± 14.68 minutes. Of these patients, four were male and one was female, and their average age was 46 ± 22.24 years (range: 18-69 years). All patients complained of unbearable ophthalmodynia immediately after surgery that was not resolved using analgesics. The ophthalmodynia resolved immediately after wearing corneal protective lenses.Conclusion: Unlike typical surgery, when shoulder surgery is performed in the beach-chair position, there is a risk of ocular surface injury due to improper head fixation; one manifestation of this problem is corneal injury. If a severe ophthalmodynia that cannot be controlled using analgesics occurs immediately after surgery in the beach-chair position, a corneal injury should be suspected, and the patient should wear a corneal protective lens.Level Of Evidence: Level IV. [ABSTRACT FROM AUTHOR]