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Ocular surface alterations in critically ill patients: An observational study.

Vishal Chaudhary1, Snigdha Sen1, Arti Agrawal2

  • 1Department of Ophthalmology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.

The Indian Journal of Medical Research
|April 4, 2026
PubMed
Summary

Critically ill patients in intensive care units (ICUs) frequently develop ocular surface disorders. Routine eye assessments and preventive care are crucial to reduce visual complications in these vulnerable patients.

Keywords:
Dry eye syndromeICUKeratitisLagophthalmosOcular surface disorders

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Area of Science:

  • Ophthalmology
  • Critical Care Medicine

Background:

  • Intensive care unit (ICU) patients face high risks of ocular surface disorders due to factors like mechanical ventilation and sedation.
  • Impaired ocular protective mechanisms and environmental conditions in ICUs exacerbate these risks.

Purpose of the Study:

  • To determine the prevalence and patterns of ocular surface alterations in ICU patients.
  • To identify risk factors associated with these alterations.
  • To analyze microbial profiles in cases of infective kerato-conjunctivitis.

Main Methods:

  • An observational study involving patients admitted to the ICU for over 72 hours.
  • Data collection included demographics, diagnoses, ocular examinations (Schirmer's test, corneal status), and conjunctival swab cultures.
  • Statistical analysis was performed to identify correlations and significant risk factors.

Main Results:

  • Corneal abnormalities were found in 71.4% of 280 patients, with keratitis/corneal ulcer being most common (31.4%).
  • Lagophthalmos and severe dry eye were significantly associated with corneal pathology (P<0.001).
  • Klebsiella sp. and Staphylococcus species were common pathogens; longer ICU stay and illness severity increased ocular morbidity.

Conclusions:

  • ICU patients exhibit a high burden of ocular surface disorders, necessitating routine ocular assessments.
  • Implementing structured preventive eye care protocols can mitigate visual complications.
  • Integrating simple eye care measures enhances overall ICU patient care quality.