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April 1979

Accidental Self-inflicted Burns as a Complication of Bilateral Patching

Arch Ophthalmol. 1979;97(4):775. doi:10.1001/archopht.1979.01020010411030

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To the Editor.  —Bilateral patching is a common practice in the treatment of many eye disorders. Problems arising from bilateral occlusion include dissociative reactions and accidental selfinflicted trauma. We would like to emphasize the dangerous combination of bilateral patching and cigarette smoking.A 72-year-old man was admitted to Barnes Hospital Retina Service, St Louis, for a retinal reattachment procedure to be performed on his left eye. His general medical condition was good. He had no coordination problems and was alert and oriented. No patching was done preoperatively. He underwent an uncomplicated retinal reattachment procedure under local anesthesia and was bilaterally patched on flat bed rest. Two eye patches (Chaston) were secured to the face with 2.5-cm paper tape. On the first postoperative day the patient freed the inferior half of the right patch by releasing the paper tape from his cheek. While the patient attempted to light a cigarette, the

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