Anesthesia and Eye Diseases: Reply

We appreciate the interest shown by Dr. Priebe¹  in our review article in Anesthesiology.²  They have provided a valuable caveat to what we wrote with respect to prevention of corneal abrasions. Dr. Priebe¹  is correct that the eyes should be properly covered immediately after loss of the eyelid reflex after induction of anesthesia. This should prevent corneal abrasion caused by objects inadvertently contacting the eye during endotracheal intubation. Using this routine, together with an educational program, as referenced by Dr. Priebe,¹  reduced the incidence of corneal injury after anesthesia from 1.51 per 1,000 to 0.79 per 1,000.³  However, corneal injury also includes exposure keratopathy (in our review, we used this term since the distinctions between exposure keratopathy and corneal abrasion may be somewhat arbitrary). Interestingly, the authors of this report found that risk factors for corneal injury included the length of surgery, as well...