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| Protection \ Corneal Shield Kit |
Ellman Corneal Shield Information
| The corneal shield is a useful aid when performing periorbital surgery. After anesthetizing the eye with topical procaine drops, the shell is easily inserted. With the patient looking downward, the corneal shield is pushed into the superior fornix. The patient is then asked to look upward, allowing the shield to be inserted into the inferior fornix. With the shield firmly in place, periorbital surgery can then be performed. To remove the shell, the patient looks medially; with the back of a forceps, pressure is applied against the rim of the shield, which pops out the device.
The corneal shield is made of methyl methacrylate. It is colored and concave-convex in appearance; it is best thought of as a thick, oversized contact lens. These are custom-made shields, measuring 16 mm in diameter, manufactured by oculist. There are also other shields that have a handle on the convex surface which facilitates insertion and removal.
The corneal shield has three major advantages.
1. Damage to the eye may be prevented, as the inserted shield protects the glove from perforatory injuries during surgery.
2. The colored lens prevents light from entering the eye, therefore the patient cannot see the surgery being performed and is more relaxed.
3. The inserted corneal shield tautens the skin, allowing the surgeon operating on thin eyelid skin to make sharp incisions.
There are a few potential problems to be aware of when using the corneal shield. Corneal abrasions can occur due to improper insertion of the shield. If the edge of the shell scratches the corneapatients will complain of a foreign-body sensation. When the shell is removed, patients have photophobia and a red eye. Treatment includes antibiotics and an eye patch. Mechanical injuries may also cause subconjunctival hemorrhages. And, of course, infections may occur if the shield has not been properly cleaned and sterilized. Inorder to prevent infections (most commonly bacterial conjunctivitis due to staphlococcus, streptococci or pseudomonas organisms), the shield should be sterilized with a disinfectant solution for 15 minutes. The concave side of the shield should be coated with antibiotic ointment.
In summary, it is easy to see that the corneal shield, if used properly, can be a safe and invaluable tool in a dermatologic practice; a true surgical gem.
Harold S. Rabinovitz, MD
Assistant Clinical Professor of Dermatology
University of Miami School of Medicine
Miami, Florida
Gil Epstein, MD
Chief of Oculoplastic Surgery
Florida Medical Center
Fort Lauderdale, FL
The Journal of Dermatologic Surgery and Oncology
Volume 11, Number 1, January 1985
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