Corneal Reflex & Imminent Death -Key Points
Corneal Reflex & Imminent Death -Key Points
Source: BMJ
Date: April 14, 2026
* Loss of corneal reflex may predict death within 24 hours
* Simple bedside test: touch cornea → assess blink response
Findings
* Absent reflex → ~5.5× higher odds of death within 24h
* 24-hour mortality rate: ~70%
Clinical Value
* More specific than many end-of-life signs
* Reflects brainstem deterioration (pons function)
* Similar to other late signs (cyanosis, death rattle)
Limitations
* Small study (112 patients)
* Mostly advanced cancer
* Moderate sensitivity
Bottom Line
Absent corneal reflex = strong indicator of imminent death (<24h)
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