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Citation
Gild WM, Posner KL, Caplan RA, Cheney FW: Eye injuries associated with anesthesia. Anesthesiology 76:204-208, 1992. [NLM PubMed Link] Order this article from: ASA Closed Claims Project.
Abstract
Claims against anesthesiologists for eye injuries were analyzed as part of the ASA Closed Claims Project. Eye injury occurred in 3% of all claims in the database (71 of 2,046). The payment frequency for eye injury claims was higher than that for non-eye injury claims (70% vs. 56%; P less than or equal to 0.05). The median cost of eye injury claims was less than that for other claims ($24,000 vs. $95,000; P less than or equal to 0.01). Two distinct subsets were identified. The first was characterized by corneal abrasion during general anesthesia (25 of 71 claims; 35%). Claims for corneal abrasion were characterized by low incidence of permanent injury (16%) and low median payment ($3,000). Reviewers were able to identify a mechanism of injury in only 20% of claims for corneal abrasion. The second subset of eye injury was characterized by patient movement during ophthalmologic surgery (21 of 71; 30%). Blindness was the outcome in all cases. Sixteen of the claims involving movement occurred during general anesthesia, and 5 occurred during monitored anesthesia care. The median payment for claim involving movement was 10 times greater than for non-movement claims ($90,000 vs. $9,000; P less than or equal to 0.01). Anesthesiologist reviewers deemed the care rendered in the general anesthesia "movement" claims as meeting standards in only 19% of claims. From the perspective of patient safety, as well as risk management, these data suggest two specific needs: research directed at better understanding of the etiology of corneal abrasion and clinical strategies designed to assure patient immobility during ophthalmic surgery.
Excerpted from Gild WM, Posner KL, Caplan RA, Cheney FW: Eye injuries associated with anesthesia. Anesthesiology 76:204-208, 1992.
A copy of the full text can be obtained from the American Society of Anesthesiologists, 520 N. Northwest Highway, Park Ridge, Illinois 60068-2573. Reprinted with permission of Lippincott Williams & Wilkins.