Evaluation of eye care and ocular findings in critically ill COVID‐19 patients

Abstract

Objective The current study aimed to evaluate eyecare needs along with ocular findings in patients treated in intensive care units because of Covid‐19 infection. Materials and Methods A total of 93 patients, 58 men and 35 women, who were under follow‐up and treatment in intensive care because of COVID‐19 infection from 1 January 2021 to 15 February 2021 were included in the study. Detailed eye examinations of the patients were performed with a portable handheld biomicroscope, direct and indirect ophthalmoscope. Cases requiring treatment for eye diseases were identified and treated. Results The mean patient age was 68.32 ± 9.97 years; 35 patients were followed up and treated with non‐invasive mechanical ventilation and 58 patients with invasive mechanical ventilation support. Mild, moderate, and severe chemosis was observed in 19 patients (20.4%), 10 patients (10.8%) and 4 patients (4.3%), respectively. Conjunctivitis (8.6%) was observed in eight patients. Corneal abrasion was present in seven patients (7.5%). Keratitis secondary to exposure keratopathy was observed in one patient. Eye care and medical treatment were initiated for these patients. We noted eight patients (8.6%) with retinal haemorrhage; however, to the best of our knowledge, these patients may show acute retinal involvement secondary to systemic diseases or have previous retinal findings other than Covid‐19 infection or treatments. Conclusion Findings of ocular involvement because of COVID‐19 infection were detected in the present study. Retinal haemorrhages were detected in addition to the common findings in viral infections. Especially in patients supported with mechanical ventilation, the detection and treatment of conditions that require eye care for exposure keratopathy are very important for recovering from the disease and the quality of vision.

Prevalence and risk factors of exposure keratopathy among critically ill patients: A systematic review and meta‐analysis

“…Included studies reported prevalence of EK between children ( n = 3 studies) (Hartford et al., 2019; Hernandez & Mannis, 1997; Narmawala & Jani, 2017) and adults ( n = 13 studies) (Aggarwal et al., 2022; Araujo et al., 2016; Casillas‐Chavarin et al., 2016; Gok et al., 2021; Hartford et al., 2019; Hernandez & Mannis, 1997; Jammal et al., 2012; Kuruvilla et al., 2015; Li et al., 2008; Mercieca et al., 1999; Narmawala & Jani, 2017; Siebert et al., 2017; Zhang et al., 2022), the main results of the meta‐analysis findings are summarized in Table 3. In individual studies, the prevalence of EK in intensive care patients ranged from 5.9% to 60.0%.…”

“…One study (Imanaka et al, 1997) included both a retrospective and prospective cohort study design, we extracted data from both study designs, so there were 24 sets of data. The frequency of cornel examination in 12 studies (Araujo et al, 2016;Germano et al, 2009;Hartford et al, 2019;Imanaka et al, 1997;Jammal et al, 2012;Kousha et al, 2018;Kuruvilla et al, 2015;Li, 2015;Li, Jin, et al, 2022;Oliveira et al, 2022;Silva et al, 2021;Werli-Alvarenga et al, 2011) is greater than or equal to five times and in the other 10 studies (Casillas-Chavarin et al, 2016;Gok et al, 2021;Hernandez & Mannis, 1997;Li et al, 2008;Martínez-García et al, 2020;Masoudi et al, 2013;Mercieca et al, 1999;Narmawala & Jani, 2017;Oliveira et al, 2022;Siebert et al, 2017) is less than five times during the studies period. Furthermore, the follow-up time in 12 studies (Araujo et al, 2016;Germano et al, 2009;Hartford et al, 2019;Imanaka et al, 1997;Kousha et al, 2018;Kuruvilla et al, 2015;Li, 2015;Li, Jin, et al, 2022;Mercieca et al, 1999;Oliveira et al, 2022;Silva et al, 2021;Werli-Alvarenga et al, 2011) is beyond 7 days and in another three studies (Jammal et al, 2012;…”

Incidence and clinical characteristic of ocular surface manifestation: an evaluation of conjunctival swab results in Corona Virus 2019 (COVID-19) patients in Jakarta, Indonesia

“…Ocular involvement in Covid-19 patients other than conjunctivitis has been described, including keratitis, uveitis, retinal pathologies, and neuro-ophthalmological involvement [ 25 , 32 , 33 ]. These clinical manifestations often occur in patients who required mechanical ventilation and in patients with more severe illness [ 20 , 34 , 35 ]. As our patients who had positive conjunctival swab results and mild symptoms of systemic Covid-19, ocular symptoms were not observed.…”

Cuidados de enfermería en la prevención de lesiones oculares en pacientes adultos críticos bajo sedación

“…Se identificó como asociado al COVID-19 el daño endotelial derivada de la inflamación vascular sistémica o sus manifestaciones tromboembólicas. Además, se detectaron hemorragias retinianas y otro tipo de mancha algodonosa asociadas 12 . Por tanto, como recomendaciones en contextos UCI con pacientes con COVID-19, se evidencia la necesidad de considerar lo siguiente: 13 a. Prevenir es fundamental en UCI.…”