To the Editor:—

Clinicians performing airway management are at risk of exposure to airborne respiratory pathogens. 1Ever since the severe acute respiratory syndrome outbreak, most anesthesiologists in Hong Kong have been wearing extra protection, including a full-face shield. On many occasions, we have witnessed the sharp lower edge of the shield to be pressing on the patient’s eye(s), potentially causing serious injuries (fig. 1).

Other objects that the anesthesiologist wears could also injure patients’ eyes, including photo-identity badges and wristwatch bands. 2Applying eye protection in patients before intubation has been suggested, 2but the process may be cumbersome and time-consuming and may interfere with other aspects of airway management (e.g. , eye goggles on the patient could interfere with bag-mask ventilation). Although removing a watch or photo-identity badge before intubation is an attractive option, removing the face shield may not be. The best protection remains the awareness that the patient’s eyes are vulnerable, and that not only what we do (or not do), but also what we wear, could cause serious injuries.


Kamming D, Gardam M, Chung F: Anaesthesia and SARS. Br J Anaesth 2003; 90: 715–8
Watson WJ, Moran RL: Corneal abrasion during induction (letter). A nesthesiology 1987; 66: 440