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VOLUME 10 , ISSUE 1 ( January, 2006 ) > List of Articles


Eye care in ICU

S Sivasankar, S Jasper, S Simon, P Jacob, G. John, R Raju

Keywords : Exposure keratopathy, Intensive care patients.

Citation Information : Sivasankar S, Jasper S, Simon S, Jacob P, John G, Raju R. Eye care in ICU. Indian J Crit Care Med 2006; 10 (1):11-14.

DOI: 10.4103/0972-5229.24683

License: CC BY-ND 3.0

Published Online: 01-04-2010

Copyright Statement:  Copyright © 2006; The Author(s).


Context: Patients in intensive care units have impaired ocular protective mechanisms, resulting in a high risk of developing eye complications. Various eye care protocols are being used, but none is proven to be absolutely effective. Aims: To compare the efficacy of using a combination of ocular lubricants and securing tape over the eyelids (Open chamber method), with use of swimming goggles and regular moistening of eyelids with gauze soaked in sterile water (Closed chamber method), to prevent corneal epithelial breakdown in the sedated and semiconscious intensive care adult patient. Settings and Design: A randomized clinical study was performed. Patients with Glasgow coma scale score of £ 10/15, admitted into the Medical ICU of a large teaching hospital, over a four month duration, were studied. Materials and Methods: Patients were examined daily by an Ophthalmologist, using a portable slit lamp and the patient′s corneas were tested daily using 1% Fluorescein drops. Standard grading scales were used to record eyelid position and corneal and conjunctival changes. Statistical analysis used: Quantitative variables were described in terms of their relative frequencies in proportions. Null hypothesis was applied to derive the statistical significance of the observed variations in both the treatment groups. Chi-square test for relationships was used to assess the effect of specific variables on the development of keratopathy. Results: Sixty one patients (122 eyes) in the open chamber group and 63 (126 eyes) in the closed chamber group, were analyzed. Incomplete lid closure was seen in 74 eyes (30%). Exposure keratopathy was noticed in 39 eyes (32%) in open chamber group and ten (8%) in closed chamber group and was more severe in the former group. There was no difference in the incidence of conjunctival oedema in both groups. Incomplete lid closure and use of muscle relaxants, were significant risk factors for developing keratopathy. Conclusions: Use of swimming goggles and regular moistening of eyelids with gauze soaked in sterile water providing a moisture chamber, is more effective than using a combination of ocular lubricants and securing tape over the eyelids, in preventing corneal epithelial breakdown in sedated and semiconscious intensive care unit patients.

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  1. Kirwan JF, Potamitis T, El-Kasaby H, Hope-Ross MW, Sutton GA. Microbial keratitis in intensive care. BMJ 1997;314:433-4.
  2. Laight SE. The efficacy of eye care for ventilated patients: outline of an experimental comparative research pilot study. Intens Crit Care Nurs 1996;12:16-26.
  3. King DJ, Healy M. Prevention of eye disease in intensive care - a telephone survey. Int Care Med 2003;29:15.
  4. Wincek J, Ruttum MS. Exposure keratitis in comatose children. J Neurosci Nurs 1989;21:241-4.
  5. Cortese D, Capp L, McKinley S. Moisture chamber versus lubrication for the prevention of corneal epithelial breakdown. Am J Crit Care 1995;4:425-8.
  6. Parkin B, Cook S. A clear view: The way forward for eye care on ICU. Intensive Care Med 2000;26:155-6.
  7. Lenart SB, Garrity JA. Eye care for patients receiving neuromuscular blocking agents or propofol during mechanical ventilation. Am J Crit Care 2000;9:188-91.
  8. Hernandez EV, Mannis MJ. Superficial keratopathy in intensive care unit patients. Am J Ophthalmol 1997;124:212-6
  9. Mercieca F, Suresh P, Marton A, Tullo AB. Ocular surface disease in intensive care unit patients. Eye 1999;13:231-6.
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