Figure 21. Extensive facial burns with lid contraction and orbital congestion. Photograph by COL Mark Reynalds
Figure 22. (A) Exposure keratopathy. Reprinted with permission of the University of Iowa and EyeRounds.org
Figure 22. (B) with fluorescein staining. Reprinted with permission of the University of Iowa and EyeRounds.org 

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

  • Detailed ocular evaluation
  • Cover eyes with polyethylene film to prevent drying.
  • Food-grade film is safe for use around the eyes.
  • Apply from the eyebrow to the maxilla to ensure proper coverage
  • No altitude restrictions for flight

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.