Background. Under normal conditions, the cornea of the eye is protected from bacterial invasion, physical injury, and drying by the presence of tears, eyelids, and blinking reflex. However, patients admitted to the intensive care unit (ICU) for several reasons including loss of consciousness, receiving sedative and neuromuscular blocking agents, and mechanical ventilation may lose eye-protective mechanisms causing exposure keratopathy. Therefore, this study intended to compare three eye care methods to prevent ocular surface disorders (OSDs) in ICU patients. Methods. This study was a double-blind clinical trial (IRCT: 201109225426N3, https://www.irct.ir/trial/5825), in which 152 patients were randomized into three groups and each group underwent a different eye care procedure. The eye care methods included simple eye ointment, polyethylene cover, and eyelid taping. The eligible patients received the care procedure for seven days, and their corneas were examined daily for OSD by a portable slit lamp with fluorescein staining. Descriptive and analytical tests (ANOVA, chi-square, logistic regression, and zero-inflated Poisson regression) were used for statistical analysis by STATA14. Results. The odds of OSD (chances of getting an OSD grade between I and VI) in the ointment group were 0.19 (95% CI: 0.09, 0.41), and the odds of OSD in the polyethylene cover group were 0.06 (95% CI: 0.01, 0.20), showing a significant difference with the tape group (p=0.0001). Despite the lower odds of OSD in the cover group than in the ointment group, there was no significant between-group difference (p=0.08). However, the mean OSD scores in both the ointment and polyethylene cover groups were significantly lower than that in the tape group. Conclusion. The results of this study showed that polyethylene cover followed by simple eye ointment and eyelid taping were the most effective methods in preventing OSD. Therefore, polyethylene cover and simple eye ointment are recommended as effective eye care methods in ICU.

Nasolacrimal duct obstruction (NLDO) is a common congenital abnormality. Some obstructions resolve spontaneously and some require probing surgery with irrigation. However, the necessity of irrigation after probing is still under doubt. The study included 131 eyes (114 children) with persistent NLDO, between 9 to 48 months of age with no previous nasolacrimal surgical procedures, who had attended the ophthalmology clinic at Shafa Hospital, Kerman, Iran for NLDO treatment. Probing was done through the superior or inferior canalicular system into the nasolacrimal canal, not succeeded by irrigation. The duration of anesthesia was shorter than usual. Subjects were visited at 1 and 6 months after surgery. Before the surgery, all of the eyes had epiphora, 56% had mucopurolent discharge and 18% had a history of dacrocystitis, in which after the surgery the prevalence dropped to 6%, 5% and 4%. The average procedure time under general anesthesia was 5.9 minutes and the average recovery time wan 7.2 minutes, which was shorter than surgery with irrigation. In this study, we experienced similar results of probing without irrigation in comparison to probing with irrigation, also the surgery and anesthesia duration was shorter and the risk of aspiration was little. More studies from other centers and larger populations especially RCTs should be performed to confirm our results.