Researchers recently found that unconscious patients admitted to intensive care units (ICUs) may not be receiving the ocular protection they need to stave off adverse effects of chronic ocular surface exposure.
This cross-sectional, observational study evaluated 87 unconscious patients (44 children and 43 adults) who ranged in age from nine days to 85 years.
The team discovered that more than 60% of participants showed signs of lagophthalmos; among those, 56.6% were children and 43.4% were adults. They note that there was no significant difference in the exposure patterns between children and adults and that exposure-related manifestations (conjunctival and corneal) were found in 56.32% of the patients.
The most common conjunctival manifestation was chemosis, which occurred in 52.83% of lagophthalmos patients. Corneal exposure was seen in 58.49% of lagophthalmos patients, with a fragile epithelium being the most common finding (32.08%). The researchers found only 54.83% of the cornea-exposed lagophthalmos eyes were taped, of which 15 were considered suboptimal, and six were unnecessarily taped. They found signs of infection in 15.09% of the lagophthalmos eyes.
Adopting and implementing eye care protocols can avert the development of these exposure-related complications and subsequent ocular morbidity—ultimately providing improved standard of care, the researchers concluded.
|Selvan H, Pujari A, Sachan A, et al. Neglected ocular surface care in critical care medicine: an observational study. Cont Lens Anterior Eye. September 2, 2019. [Epub ahead of print].|