The effect of eye care protocol on the prevention of ocular surface disorders in patients admitted to intensive care unit

Mobarez, Fariba; Sayadi, Neda; Jahani, Simin; Sharhani, Asaad; Savaie, Mohsen; Farrahi, Fereydoun

doi:10.25122/jml-2022-0139

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…Antihistamines, atropine, phenothiazines, and tricyclic antidepressants, often used in the ICU, can decrease tear duct activity. Patients that are unconscious in the ICU additionally cannot express eye complaints, allowing ocular diseases to progress without notice [ 12 ]. Our patient also experienced possible corneal trauma with the motor vehicle accident, giving another risk for an FK exposure [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Fungal Keratitis in a Critically Ill Post-trauma Patient

Pulliam,

Nkangabwa,

Lantz

et al. 2023

Cureus

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Keratitis is the leading cause of corneal blindness in the world. Nearly half the cases are due to a fungal infection known as fungal keratitis (FK). There is much variability in the clinical presentation of FK, so diagnosis can be difficult. With the risks of blindness in disease progression being so high, it is vital to diagnose and treat FK quickly. We present a case of FK due to Candida albicans and Staphylococcus lugdunensis-oxa ss after a motor vehicle accident, its treatment, and the general outcome.A 71-year-old man with a history of hypertension, hyperlipidemia, arthritis, and previous tobacco use presented after a helmeted motorcycle accident with back pain and bilateral lower extremity sensory and motor function loss. He suffered many fractures and was in neurogenic shock. He had nearly daily reduction and fixation of multiple axial spinal fractures while in the surgical intensive care unit and was ultimately unable to be successfully extubated. Between two intubations, he complained to his family of blurry vision, and there was notable purulence and corneal haziness in bilateral eyes.The healthcare team initially suspected the eye infection was due to a bacterial etiology, and he was subsequently diagnosed with Pseudomonas pneumonia on respiratory cultures. However, several days of antibiotics did not improve the ocular exam. A corneal culture was positive for C. albicans and S. lugdunensis-oxa ss, and anti-fungal treatment was initiated with ocular improvement. Unfortunately, the patient succumbed to his injuries and further sepsis at another site. With a progressively poor prognosis and machine dependence, he was made do-not-resuscitate per family wishes and died within two hours after cessation of hemodialysis.One of the greatest barriers to diagnosing FK in the United States is the absence of information regarding the disease. Though novel diagnoses and treatment strategies are in development, the fungal etiology of keratitis should be included in the curricula for not just medical students but also for providers and specialists, as the incidence of FK continues to grow with globalization. We also aim to emphasize the importance of a multidisciplinary team in these cases, as ophthalmology and infectious disease specialists should be involved immediately in order to improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

“…Methods included taping patients’ eyes shut, using ophthalmic lubricants such as 0.3% hypromellose teardrops, and covering the eyes with contact lenses and polyethylene rings. Through these practical and low-maintenance protocols, the incidence of FK and other ocular diseases in the ICU decreased dramatically [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Fungal Keratitis in a Critically Ill Post-trauma Patient

Pulliam,

Nkangabwa,

Lantz

et al. 2023

Cureus

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“…In addition, Kousha et al, (2018) have demonstrated that the implementation of this protocol significantly decreases eye complications in clinical practice and is easy to implement. Furthermore, Mobarez et al, (2022) have shown a reduction in keratitis, conjunctivitis, dried eye, and corneal ulceration when patients are treated with an Eye Care Protocol. Pourghaffari Lahiji et al, (2021) reported that it has been demonstrated that the implementation of a protocol for eye care significantly reduced ocular complications.…”

Section: Post-implementation Phase Of Eccgmentioning

confidence: 99%

“…Pourghaffari Lahiji et al, (2021) reported that it has been demonstrated that the implementation of a protocol for eye care significantly reduced ocular complications. Similarly, Sama et al, (2023) concluded that applying a protocolized eyecare bundle has significantly reduced the incidence of exposure keratopathy among vulnerable critically ill patients such as sedated mechanically ventilated patients (Azam Pourghaffari Lahiji, Mohsen Gohari, 2021; Mobarez et al, 2022;Sama et al, 2023).…”

Section: Post-implementation Phase Of Eccgmentioning

confidence: 99%

Effect of Eye Care Clinical Guidelines Training on Critical Care Nurses’ Competency and Eye Complications among Critically Ill Patients

Hemida Salem

2024

Egyptian Journal of Health Care

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Background: Nursing care of eyes is considered a basic nursing intervention in critically ill patients. However, it is sometimes neglected due to the focus on supporting vital body functions. These patients are at great risk of eye disorders as a result of their medical conditions and treatment that can alter the eye protective mechanisms, such as the use of ventilatory support and sedation. Preventing eye problems requires improving the critical care nurses' competency through continuous pre-service education, hands-on experience, and in-service training. Aim: Assess the effect of eye care clinical guidelines training on critical care nurses' competency and eye complications among critically ill patients. Methods: Interventional research using a pre-post design was used to assess and compare nurses' scores before and after the ECCGs training. A Convenient sample of all nurses (75) who worked in the critical care unit in the Main University Hospital at Alexandria University and agreed to participate in the study was enrolled in the study. In addition, a purposive sample of 100 adult patients who had eligible criteria was included in the study. The data of the current study were collected by using three tools namely "eye care clinical competency questionnaire", "Patient's eye assessment record", and "Superficial ocular surface disorders assessment scales package". Results: A total of 75 nurses and 100 critically ill patients participated in the current study. The percent scores of post-implementation nurses' eye care knowledge and practice were significantly higher than their pre-implementation scores (p ≤ 0.001) respectively. However, there was no significant difference between the nurses' attitude scores (p 0.147). Additionally, the percent scores of eye complications were 84% in patients who received care from nurses before attending the in-service training compared to 46% of eye complications among the patients who received care from nurses after attending the in-service training with a high significant difference between both studied groups (p <0.001). Conclusion: Implementing ECCGs significantly improved eye care nurses' knowledge, and practice, which contributed to reducing the occurrence of eye complications among critically ill patients.

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The effect of polyethylene cover intervention on ocular surface disorder of intensive care unit patients: a systematic review and meta-analysis

Askaryzadeh Mahani,

Nematollahi,

Bahramnezhad

et al. 2024

BMC Ophthalmol

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Background Polyethylene covers have been proven to be effective in protecting the eyes in patients with decreased or disappeared blink reflexes, but their advantages compared to other conventional methods are still unclear. This systematic review and meta-analysis study aimed to elucidate the impact of polyethylene covers in the prevention of ocular surface disease (OSD) in patients admitted to the intensive care unit (ICU). Methods We searched the Scopus, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify randomized controlled trial studies. This study followed the PRISMA guidelines and used the Cochrane Collaboration tool to assess the risk of bias. Results The findings were expressed as risk ratio (RR) with 95% confidence intervals. The incidence of OSD in the polyethylene cover group was lower than that in the eye drops group (RR = 0.27; 95% CI (0.07, 1.09), P = 0.07) and adhesive tape group (RR = 0.11, 95%CI (0.04, 0.31), P < 0:0001) but the polyethylene cover group showed no significant difference compared to the eye gel group (RR = 0.79, 95%CI (0.18, 3.51), P = 0.76) and the eye ointment group (RR = 0.85; 95% CI (0.36, 1.99), P = 0.71). Conclusion This study showed that polyethylene covers, eye gels, and eye ointments had an equal effect on preventing OSD in ICU patients, and eye drops and adhesive tapes were relatively less effective. However, other intervention methods had not been compared due to the small number of articles. Hence, further studies should assess the available methods to choose the best practical method.

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The effect of eye care protocol on the prevention of ocular surface disorders in patients admitted to intensive care unit

Cited by 3 publications

References 15 publications

Fungal Keratitis in a Critically Ill Post-trauma Patient

Fungal Keratitis in a Critically Ill Post-trauma Patient

Effect of Eye Care Clinical Guidelines Training on Critical Care Nurses’ Competency and Eye Complications among Critically Ill Patients

The effect of polyethylene cover intervention on ocular surface disorder of intensive care unit patients: a systematic review and meta-analysis

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