Goal
Prevent ocular exposure and corneal injury in high risk patients.
Minimum
Initiate ocular surface protection with sterile petrolatum or methylcellulose drops to keep the ocular surface from drying out. (Do not substitute a nonophthalmic lubricant).
For thermal facial burns, instill erythromycin ophthalmic ointment or sterile petrolatum every 2 to 4 hours.
Better
Gentle horizontal taping of lids with hypoallergenic tape in conjunction with ocular surface protection to protect the eyes.24
Evaluate the eyes and instill a surface protectant at least every 8 hours. Ensure the surface of the eye is not dry, there is no pressure on the eye, pupil reactivity has not changed, and the eyelids are completely closed to protect the eye.
Best
NOTE: Surgilube should never be instilled into the eye as a lubricant, because if can cause corneal toxicity.18 When used for ultrasound examination, place a thin film (e.g., food-grade polyethylene or Tegaderm [3M, http://www.3m. com]) over the closed eyelid.