Eye injuries associated with anesthesia. A closed claims analysis.

Area of Science:

• Anesthesiology
• Ophthalmology
• Patient Safety
• Risk Management

Background:

• Eye injuries represent a significant concern in anesthesiology claims.
• The ASA Closed Claims Project database was analyzed to understand the scope and characteristics of eye injury claims.

Purpose of the Study:

• To analyze the incidence, characteristics, and outcomes of eye injury claims in anesthesiology.
• To identify specific subsets of eye injuries and their associated risk factors and costs.
• To inform strategies for improving patient safety and risk management in ophthalmic surgery.

Main Methods:

• Analysis of 2,046 claims from the ASA Closed Claims Project database.
• Categorization of eye injury claims into distinct subsets based on mechanism and outcome.
• Review of medical records and anesthesiologist assessments for claims involving patient movement.

Main Results:

• Eye injuries constituted 3% of all claims, with higher payment frequency but lower median cost than non-eye injury claims.
• Corneal abrasion during general anesthesia was a common subset (35%), typically resulting in low permanent injury and low costs.
• Patient movement during ophthalmic surgery (30%) led to blindness in all cases, with significantly higher median payments and a high proportion of substandard care.

Conclusions:

• Two primary types of anesthesiology-related eye injuries require attention: corneal abrasions and injuries due to patient movement during ophthalmic surgery.
• Further research into the causes of corneal abrasions and development of strategies to ensure patient immobility during eye procedures are crucial.
• Addressing these issues can improve patient safety and reduce the financial and clinical burden of eye injuries in anesthesiology.