Abstract
Patients in intensive care units (ICU) are at increased risk of corneal abrasions and infectious keratitis due to poor eyelid closure, decreased blink reflex, and increased exposure to pathogenic microorganisms. The aim of this retrospective study was to evaluate the ocular surface problems in patients who stayed in ICU more than 7 days and were consulted by an ophthalmologist. There were 26 men and 14 women with a mean age of 40.1 ± 18.15 years (range 17–74 years). Conjunctiva hyperemia, mucopurulent or purulent secretion, corneal staining, and corneal filaments were observed in 56.25%, 36.25%, 15%, and 5% of the eyes, respectively. Keratitis was observed in 4 patients (10%) who were treated successfully with topical antibiotics. Mean Schirmers test results were 7.6 ± 5.7 mm/5 min (median 6.5 mm/5 min) in the right, and 7.9 ± 6.3 mm/5 min (median 7 mm/5 min) in the left eyes. Schirmers test results were <5 mm/5 min in 40% of the subjects. The parameters did not show statistically significant difference according to mechanical ventilation, sedation, and use of inotropes. As ICU patients are more susceptible to develop dry eye, keratopathy, and ocular infections, they should be consulted by an ophthalmologist for early diagnosis of ocular surface disorders.
Highlights
Patients in intensive care units (ICU) are at increased risk of corneal abrasions and infectious keratitis due to impaired ocular defence mechanisms such as poor eyelid closure, inhibition of Bell’s phenomenon, decreased blink reflex, reduced tear production, and increased exposure to pathogenic microorganisms [1,2,3,4,5,6,7].ICU medical and nursing staff are primarily concerned with life threatening conditions; the ocular signs and symptoms may be missed leading to serious ocular complications including corneal ulceration and infectious keratitis [1, 2]
Meticulous eye care with regular cleaning of the eyes, installation of lubricating drops and ointments, and consultation from an ophthalmologist in case of a suspected infection [8,9,10,11] are recommended. The aim of this retrospective study was to evaluate the prevalence of ocular surface disorders in patients who stayed in ICU more than 7 days and were consulted by an ophthalmologist
Blink reflex was negative in 12 subjects (30%), Bell phenomenon was absent in 30 subjects (75%), and pupillary reflex was negative in 2 subjects (5%)
Summary
Patients in intensive care units (ICU) are at increased risk of corneal abrasions and infectious keratitis due to impaired ocular defence mechanisms such as poor eyelid closure, inhibition of Bell’s phenomenon, decreased blink reflex, reduced tear production, and increased exposure to pathogenic microorganisms [1,2,3,4,5,6,7].ICU medical and nursing staff are primarily concerned with life threatening conditions; the ocular signs and symptoms may be missed leading to serious ocular complications including corneal ulceration and infectious keratitis [1, 2]. Ocular complications lead to corneal opacities and even perforation which will seriously impair visual acuity and quality of life For these reasons, meticulous eye care with regular cleaning of the eyes, installation of lubricating drops and ointments, and consultation from an ophthalmologist in case of a suspected infection [8,9,10,11] are recommended. Meticulous eye care with regular cleaning of the eyes, installation of lubricating drops and ointments, and consultation from an ophthalmologist in case of a suspected infection [8,9,10,11] are recommended The aim of this retrospective study was to evaluate the prevalence of ocular surface disorders in patients who stayed in ICU more than 7 days and were consulted by an ophthalmologist
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