Corneal abrasions result from disruption of the corneal epithelium, usually as the result of direct trauma to the cornea. Common
scenarios include direct injury from stethoscopes, identification badges, and watches during intubation; improper face-mask positioning or surgical draping; and even the patient himself rubbing his eyes.

Exposure keratitis (EK) is inflammation of the cornea from exposure and drying of the corneal epithelial surface. The most common cause of EK during anesthesia is lagophthalmos or incomplete closure of the eyelids for prolonged periods. Partial exposure of the eye, coupled with decreased tear-film production and stability, leads to breakdown of the corneal epithelium. Sequelae of EK include epithelial defects, corneal infiltrates, ulceration, perforation, and even endopthalmitis.

Chemical keratitis is serious eye condition, resulting from exposure of the eye socket and globe to potentially toxic substances, such as surgical preparatory solutions. A commonly used agent for surgical scrubs is Hibiclens, a preparation of 4% chlorhexidine antiseptic solution and detergent. Remember that in very dilute concentrations (0.005%), chlorhexidine is a valuable ophthalmologic agent and has been used as a preservative for soft and gas-permeable contact-lens solutions. Also, concentrations of 0.02% can be used with propamide to treat Acanthamoeba keratitis. However, the 4% solution should be considered toxic to the eye. Injuries usually involve epithelial defects associated with epithelial-cell death and desquamation, which is potentiated by the presence of the detergent. Other described injuries include conjunctival hyperemia, chemosis, hypotony, anterior-chamber flare, and corneal edema. Rarely, exposure to large amounts of chlorhexidine has necessitated corneal transplant.