Risk factors assessment of ocular surface disorders among adult critically ill patients

Abstract

Ocular complications are common in the critical care setting but are frequently missed due to the focus on life-saving organ support. In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. This study aims to: assess risk factors for ocular surface disorders among adult critically ill patients. Design: Exploratory research design. This study was carried in intensive care units at Assiut university hospital. Subjects: A convenience sampling of 60 adults patients. Tools: Two tools were utilized to collect data of study, tool I: Patient assessment sheet. Tool II: Risk factors assessment sheet. Method: The researcher assessed risk factors, eye lid closure and occurrence of ocular surface disorders. Results: The exposure of adult critically ill patients to ocular surface disorders was high related to right eye were 51% in 7 th day, related to left eye were 48% in 5 th day. Regarding type of abnormalities in right eye, the result revealed that 80.8% were mixed in 6 th day and 3.2% were corneal abrasion in7 th day. Conclusion: The study confirmed that important risk factors for ocular surface disorders in Intensive Care Unit (ICU) patients were: lagophthalmos, level of consciousness, mechanical ventilation, sedation and muscle relaxant, length of ICU stay, fluid misdistribution and respiratory microorganism. Recommendation: It is necessary to disseminate protocols and guidelines for eye care in ICU patients to reduce the risk.

Development and Validation of Eyes Care Bundle for Mechanically Ventilated Patients

“…It can result in visual impairment and a lower quality of life by causing eye dryness, infection, ulcerations, even perforation, and iatrogenic mechanical corneal damage. 31 This report supports the finding of the study "A bundle improves eye care in PICU" by McCall et al, which found that longer critical care stay and partial eyelid closure were risk factors for the development of corneal surface abnormalities. 32 Additionally, it was discovered by Kuruvilla et al that closing the eyelids acts as a mechanical protection against corneal exposure and drying.…”

“…They did not have spontaneous eye opening, and the frequency of blinking was limited. It can result in visual impairment and a lower quality of life by causing eye dryness, infection, ulcerations, even perforation, and iatrogenic mechanical corneal damage 31. This report supports the finding of the study “A bundle improves eye care in PICU” by McCall et al, which found that longer critical care stay and partial eyelid closure were risk factors for the development of corneal surface abnormalities 32.…”

Ocular dryness in intensive care: proposal for a new nursing diagnosis

“…Such exposure may result in increased tear film evaporation and dryness of the ocular surface ( 28 ) . Study points out in its results the exposure of the eyeball as the main risk factor for alterations of the ocular surface ( 1 ) .…”

“…Thus, they generally require complex care, ventilatory assistance, invasive procedures and the use of various medications, such as sedatives and neuromuscular blockers to maintain clinical therapy and vital parameters, which can lead to ocular changes. In this way, the importance of eye care is emphasized in order to avoid complications on the ocular surface until the possible evolution to vision loss ( 1 , 2 ) .…”

Ressecamento ocular em terapia intensiva: proposta de novo diagnóstico de enfermagem

“…Assim, geralmente, necessitam de cuidados complexos, assistência ventilatória, procedimentos invasivos e uso de variados medicamentos, como sedativos e bloqueadores neuromusculares, para manutenção da terapêutica clínica e dos parâmetros vitais, que podem levar a alterações oculares. Dessa forma, ressalta-se a importância do cuidado ocular no sentido de evitar complicações na superfície ocular até a possível evolução para a perda da visão (1)(2) .…”