title: A Department-of-Anesthesiology-based management protocol for perioperative corneal abrasions.
abstract: BACKGROUND
  Corneal abrasions (CAs) are the most prevalent ocular injuries in the perioperative period. Previously, patients at our community hospital would wait for an ophthalmologist to be available to manage these minor injuries. To decrease this waiting period - and thereby increase patient satisfaction - we developed an anesthesiology-based protocol to manage minor CAs arising in the recovery room. The current study sought to assess this protocol's efficacy as well as further establish the incidence and some risk factors of CA.
  
  
  METHODS
  This was a hospital-based, observational study. As per protocol, anesthesiologists saw and diagnosed any patient exhibiting symptoms of CA, after which they initiated a preestablished treatment regimen. To examine the efficacy of this protocol between March 2007 and December 2011, the number of CAs anesthesiologists managed and time to treatment were recorded. Additionally, the frequency of CAs was established along with some of their risk factors.
  
  
  RESULTS
  Throughout the study period, there were 91,064 surgical cases, with 118 CAs (0.13% incidence). Anesthesiology alone managed 110 (93.22%) of these cases. The median time between the end of anesthesia to the time of prescribed ophthalmic medication was 156 minutes (first-third interquartile range: 108-219). All patients experienced resolution of symptoms by the morning following their complaint. Compared to the general surgical population, CA patients were older (P<0.01) and underwent longer surgeries (P<0.01).
  
  
  CONCLUSIONS
  Minor CAs can be safely and effectively managed using an anesthesiology-based approach. Advanced age and longer surgery are confirmed as risk factors for these injuries.
authors.affiliation: Division of Clinical Research, Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Lichter
authors.affiliation: University of Pittsburgh Physicians, Department of Anesthesiology, UPMC Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Lawrence B
authors.initials: LB
authors.lastname: Marr
authors.affiliation: UPMC Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Dennis E
authors.initials: DE
authors.lastname: Schilling
authors.affiliation: University of Pittsburgh Physicians, Department of Anesthesiolgy, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Hudson
authors.affiliation: Department of Anesthesiology, UPMC Shadyside, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Boretsky
authors.affiliation: Department of Ophthalmology, UPMC Shadyside, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Roxana F
authors.initials: RF
authors.lastname: Barad
authors.affiliation: Division of Clinical Research, Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, USA ; University of Pittsburgh Physicians, Department of Anesthesiology, UPMC Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA ; UPMC Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Jacques E
authors.initials: JE
authors.lastname: Chelly
keywords: clinical protocols; corneal injuries; patient care management; perioperative complications