OPHTHALMIC INJURY

- Every patient with facial burns should have a thorough eye exam, including Wood’s lamp exam with fluorescein, when available. If available, consult an ophthalmologist for all patients with facial burns or corneal injury verified by Wood's lamp exam. Eye exams should be done early, before facial edema sets in.
- If no injury exists, lubricate the eyes of intubated patients every 2 hours with Lacri-lube.
- If a corneal injury is identified, use a Fox shield to cover the eyes and apply ophthalmic erythromycin ointment at least every 2 hours.
- If there is suspicion of an open globe injury, no drops or ointment should be applied, place a Fox eye shield, and refer to an ophthalmologist as soon as possible.
- If resuscitation exceeds 200 mL/kg/TBSA, and/or in the presence of full thickness periorbital burns, perform intraocular pressure measurement using a tonometer (and consult an Ophthalmologist); the patient may require urgent lateral canthotomy and cantholysis.

Refer to Eye Trauma: Initial Care CPG for additional information.4