Neglected ocular surface care in critical care medicine: An observational study

Area of Science:

• Ophthalmology
• Critical Care Medicine

Background:

• Unconscious patients in intensive care units (ICUs) are at high risk for ocular complications due to impaired eyelid function.
• Lagophthalmos, the inability to close the eyelids completely, can lead to exposure keratitis and other serious eye conditions.

Purpose of the Study:

• To determine the prevalence of lagophthalmos and associated ocular complications in unconscious patients.
• To assess the current eye care practices and identify areas for improvement in a tertiary care setting.

Main Methods:

• A cross-sectional observational study was conducted.
• 87 unconscious patients (44 children, 43 adults) admitted to ICUs/wards were included.
• Data on lagophthalmos, exposure manifestations, and eye care interventions were collected and analyzed.

Main Results:

• Lagophthalmos was observed in 60.91% of patients, with similar prevalence in children and adults.
• Ocular surface exposure (conjunctival/corneal) occurred in 56.32% of patients, with chemosis and fragile epithelium being common findings.
• Inadequate and sub-optimal eye taping was noted in a significant proportion of exposed eyes, and 15.09% showed signs of infection.

Conclusions:

• Lagophthalmos and its complications are highly prevalent in unconscious ICU patients.
• Current eye care practices, particularly eyelid taping, are often suboptimal, increasing the risk of ocular morbidity.
• Implementing systematic eye care protocols is essential to prevent severe ocular complications and improve patient outcomes.