Highlights
- •Ocular surface disorders (OSD) have been observed in nearly 60% of critically ill patients.
- •The eye is more often looked at as a diagnostic aid, and the return reward of care has not been reciprocal.
- •A simple test of observing torch light reflection from the cornea can help pick up early signs of exposure keratopathy.
- •Optimal eye care in unconscious patients can avert development of exposure-related complications and subsequent ocular morbidity.
Abstract
Aim
To study the prevalence of lagophthalmos and its related complications among the unconscious
patients admitted in the intensive care units (ICU)/wards of a tertiary care centre.
Methods
Cross-sectional observational study.
Results
A total of 87 unconscious patients were included. 44 were children and 43 were adults.
The overall median age of patients was 16 years (range: 9 days- 85 years). 53/87 (60.91%)
showed signs of lagophthalmos, among which 56.60% (30/53) were children and 43.40%
(23/53) were adults. There was no significant difference in the exposure patterns
between children and adults (p = 0.25). Exposure related manifestations (conjunctival/corneal)
were found in 49/87 patients (56.32%). The most common conjunctival manifestation
was chemosis, occurring in 28/53 patients (52.83%). Corneal exposure was seen in 31/53
patients (58.49%), of which fragile epithelium was the commonest finding (32.08%).
Only 17/31 (54.83%) cornea exposed eyes were taped, of which 15 were sub-optimal.
6 patients were unnecessarily taped. Signs of infection were noted in 8/53 eyes (15.09%).
Conclusion
Optimal eye care in unconscious patients can avert the development of exposure-related
complications and subsequent ocular morbidity. Adoption and implementation of systematic
protocols can help improve the standard of care.
Keywords
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Article info
Publication history
Published online: September 02, 2019
Accepted:
August 19,
2019
Received in revised form:
August 11,
2019
Received:
June 3,
2019
Identification
Copyright
© 2019 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
