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Ocular surface disorders in the critically ill

H Imanaka1, N Taenaka, J Nakamura

  • 1Intensive Care Unit, Osaka University Hospital, Japan. imanakah@hsp.ncvc.go.jp

Anesthesia and Analgesia
|August 1, 1997
PubMed
Summary
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Critically ill patients often develop ocular surface disorders, particularly when sedated or immobilized. Inability to fully close eyes significantly increases corneal erosion risk, but eyelid taping can help.

Area of Science:

  • Ophthalmology
  • Critical Care Medicine

Background:

  • Ocular surface disorders are linked to various conditions including neurological diseases, coma, and mechanical ventilation.
  • Critically ill patients are susceptible to corneal and conjunctival abnormalities.

Purpose of the Study:

  • To investigate the incidence and causes of ocular surface disorders in critically ill patients.
  • To determine the impact of sedation, neuromuscular blockade, and eye closure on ocular surface health.

Main Methods:

  • Retrospective chart review of 143 mechanically ventilated patients (ICU stay ≥7 days) for conjunctivitis and corneal erosion.
  • Prospective study of 15 continuously sedated/paralyzed ICU patients, examining corneal erosion daily via slit lamp.
  • Assessing the effect of eyelid closure and protective taping.

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Main Results:

  • 20% of patients with ICU stay >7 days had ocular surface disorders.
  • Incidence of disorders increased with continuous sedation (35%) and neuromuscular blockade (39%).
  • In the prospective group, 60% developed corneal erosion; inability to close eyes was a significant risk factor (P < 0.01).

Conclusions:

  • Critically ill patients frequently develop ocular surface disorders, especially when sedated and immobilized.
  • Impaired eye closure is strongly associated with increased corneal erosion risk.
  • Protective eyelid taping is an effective intervention for prevention and treatment.