The use of non-invasive ventilation (NIV) devices such as continuous positive airway pressure and bi-level positive airway pressure machines have been associated with an increased incidence of dry eye disease (DED). To understand how the use of these ventilation masks impacts the eyes, a review of the pathophysiology of DED and an evaluation of recent studies investigating the effects of NIV use on the severity and incidence of this condition were performed. It was found that the use of face masks associated with the ventilation devices exhibited a positive correlation to the incidence and severity of numerous ocular pathologies. However, the benefits of non-invasive mechanical ventilation are undeniable in treating conditions such as obstructive sleep apnea, chronic obstructive pulmonary disease, and respiratory failure; therefore, proper education, behavioral modifications, and treatment can help reduce or prevent the adverse effects that NIV have on the eyes.

Diabetic ketoacidosis (DKA) is a life-threatening complication in patients with Type 1 or Type II. Diabetes Mellitus resulting in fluid shifts, electrolytes imbalance and acid-base disorders, can lead to multi-organ Failure. The Pancreas and skeletal muscles are not commonly affected in DKA. We present a case of 41-year-old female who was initially admitted in intensive care unit for treatment of Diabetic ketoacidosis, and was treated appropriately later she complained of abdominal pain and generalized myalgia. Hospital course was complicated with Acute pancreatitis and Rhabdomyolysis. Serum electrolytes were significant for hypo-phosphatemia. Workup for myositis and acute pancreatitis were negative. The exact etiology is unknown, but it is proposed in many literature articles that serum hyper-osmolarity and/or electrolyte abnormalities can be the culprits in triggering the complications.