- •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.
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.
Cross-sectional observational study.
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%).
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.
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Published online: September 02, 2019
Accepted: August 19, 2019
Received in revised form: August 11, 2019
Received: June 3, 2019
© 2019 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.