Exposure keratopathy and conjunctival microbial flora in mechanically ventilated patients - A hospital-based...

Patients on prolonged mechanical ventilation are at risk of exposure keratopathy and conjunctival microbial colonization. This study aimed to evaluate the incidence of exposure keratopathy and the pattern of conjunctival microbial flora in mechanically ventilated ICU patients.

Ocular evaluation for the presence of EK using fluorescein dye and grading was done in patients on mechanical ventilation in ICUs. Conjunctival swabs from these patients were analyzed for culture and sensitivity on day 3 and day 7. Regular follow-up was done.

A total of 52 patients were included with a mean age of 51.57 ± 16.65 years, with sepsis (28%) as the most common cause for admission. 32% of patients had EK, and the most common organisms found in different grades of EK were Staphylococcus haemolyticus in grade 1, Acinetobacter baumannii in grade 2, and Pseudomonas aeruginosa in grade 3. The most common commensal found in our study was Staphylococcus epidermidis (52%), and the noncommensal was Staphylococcus aureus (11%). Pseudomonas aeruginosa and Candida albicans were found to be present only on day 7 of the ICU care. Conjunctival culture yielded the same organism as in the endotracheal tube culture result in 13.5% of the cases.

Eye care in critically ill patients on mechanical ventilation is often ignored, and it can lead to rare but potentially devastating complications such as corneal perforation and endophthalmitis, which have long-term consequences on a patient's quality of life. Hence, it is essential to monitor eye care, assess EK, and manage at the earliest with a standard eye care protocol for mechanically ventilated ICU patients.