Effective management of exposure keratopathy developed in intensive care units: The impact of an evidence based eye care education programme

Abstract

To assess the impact of eye care education on the incidence of corneal exposure in intensive care units (ICU). Approximately 300 ICU personnel were educated about eye care to reduce the incidence of corneal exposure. The patients were divided into two groups: pre-training (Group 1: Between February 1, 2011 and March 31, 2011 [2 months]) and post-training periods (Group 2: Between April 1, 2011 and April 1 2012 [1 year]). We compared the groups for keratopathy incidence to evaluate the efficacy of this education. The number of patients were 762 in Group 1 and 6196 in Group 2 (p = 0.335). Medians of patients followed in pre training ICU and post training ICU for each month were found to be 476 (interquartile range, 433-539) and 515 (interquartile range, 490-528). Exposure keratopathy was identified in 8 eyes of 6 patients (3 males and 3 females) in pre training ICU with the mean age of 27.6 ± 31.8 years and 5 eyes of 3 patients (1 male and 2 females) in post training ICU with the mean age of 41.3 ± 32.1 years. No significant difference was noticed between two groups in terms of the medians of patients followed in ICUs for each month (p=0.335). The time of hospitalisation in ICU when the patients were consulted for the first ocular assessment in pre training ICU and post training ICU were found to be 13 ± 8.7 days and 8 ± 1.7 days, respectively. After the training, the decrease in incidence of exposure keratopathy was found to be highly significant (p < 0.001). We observed a highly significant reduction in the incidence of corneal exposure, following the eye-care education programme.