Corneal Abrasion
One common complication of surgery often noted postoperatively is a corneal abrasion. It can occur due to several factors related to the surgical procedure or postoperative care. We present a general overview:
What Is a Corneal Abrasion?
This is a superficial injury to the surface of the eye which happens during surgery.
A corneal abrasion is a scratch or injury to the epithelium, the outermost layer of the cornea—the clear, dome-shaped surface that covers the front of the eye
Many believe It happens if the eye is not completely closed while asleep and is then left exposed. It can be painful and cause significant discomfort, especially after eye surgery when the eye is already sensitive.
Causes After Surgery
Corneal abrasions post-surgery can result from:
- Surgical instruments accidentally contacting the cornea.
- Improper use of eyelid speculums or drapes during surgery.
- Dry eye or inadequate lubrication during or after surgery.
- Contact with foreign bodies, such as debris or sutures.
- Improper handling of contact lenses used as bandages.
- Patient rubbing the eye postoperatively.
- Use of an oxygen face mask while the patient is on their side.
Symptoms
Patients with a corneal abrasion may experience:
- Sharp or burning eye pain
- Redness and tearing
- Blurred vision
- Photophobia (sensitivity to light)
- A sensation of something in the eye
- Swollen eyelids
Diagnosis
When an individual complains of eye pain immediately after surgery the anesthesia team will take steps to make a diagnosis.
The Diagnosis is typically made using the following:
- Slit-lamp examination
- Fluorescein dye test, which highlights the abrasion under blue light
Fluorescein Dye Test
Treatment
Treatment aims to relieve symptoms, prevent infection, and promote healing:
- Antibiotic eye drops or ointments (e.g., erythromycin, ciprofloxacin) to prevent infection
- Lubricating drops or ointments to keep the eye moist
- Pain relief with oral NSAIDs or topical analgesics
- Bandage contact lenses to protect the cornea and reduce discomfort
- Eye patching (less common today)
- In rare cases, surgical intervention like superficial keratectomy may be needed for persistent or severe abrasions.
Prognosis
Most corneal abrasions heal within 24 to 72 hours. However, complications like recurrent corneal erosion syndrome or corneal ulcers can occur if not properly managed.
