Assessing an Exposure Keratopathy Prevention Strategy in Mechanically Ventilated Patients: A Retrospective Study

Area of Science:

• Ophthalmology
• Critical Care Medicine
• Patient Safety

Background:

• Intubated and sedated patients in intensive care units (ICUs) face a significant risk of exposure keratopathy (EK), potentially leading to irreversible vision loss.
• Proactive measures are crucial to mitigate ocular surface complications in critically ill patients.

Purpose of the Study:

• To evaluate the effectiveness of a newly implemented
• Exposure Keratopathy Prevention Order Set
• in reducing the incidence of EK among mechanically ventilated ICU patients.

Main Methods:

• A retrospective chart review was conducted at a tertiary care hospital.
• The study compared EK incidence in ventilated patients before and after the order set's implementation.
• The order set mandated the application of lubricating eye ointment every six hours.

Main Results:

• The incidence of EK diagnoses decreased from 4.5% before the order set to 2.2% after implementation.
• While not statistically significant (P = 0.154), the risk ratio was 0.50, suggesting a potential benefit.
• The number of ophthalmology consults for EK showed a slight increase in absolute numbers but a decrease relative to the patient population.

Conclusions:

• The implementation of the EK Prevention Order Set demonstrated a trend toward a reduction in EK diagnoses among ventilated ICU patients.
• The findings suggest that standardized protocols for ocular lubrication can help prevent exposure keratopathy in high-risk patient populations.