COVID-19: The Role of the Ophthalmologist in ICU

Bhalla, Minak; Jolly, Rohit; Jain, Saurabh

doi:10.1080/08820538.2020.1843687

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…This study confirmed the influence of risk factors already known from other reports [3,13], such as the presence of injuries (p < 0.01), the use of sedation drugs (p < 0.01), mechanical ventilation (p < 0.05), and lagophthalmos (p < 0.001).…”

Section: Discussionsupporting

confidence: 89%

“…The risk of ocular complications increases in persons with general injuries, craniofacial injuries (especially in the eye sockets [5]), in unconscious patients with severe conditions [3], and in respiratory system infections and ventilator-associated pneumonia (VAP). Another risk factor is the use of mechanical ventilation including Positive End-Expiratory Pressure (PEEP) and Continuous Positive Airway Pressure (CPAP), oxygen masks, and prone position [2,[12][13][14][15]. Patients treated with sedatives, tranquilizers, and neuromuscular blockers are also at greater risk of developing eye complications [2,16].…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit

Płaszewska‐Żywko

Sega

Bukowa

et al. 2021

IJERPH

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In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. In addition, many other factors related to patients’ severe condition and treatment contribute to ocular surface disease. Reducing risk factors and proper eye care can have a significant impact on incidences of eye complications and patient quality of life after discharge from the intensive care unit (ICU). The aim of the study was to determine risk factors for ocular complication, especially those related to nursing care. The study was conducted in the ICU of a university hospital. Methods for estimating and analyzing medical records were used. The patient’s evaluation sheet covering 12 categories of risk factors for eye complications was worked out. The study group included 76 patients (34 patients with injuries and 42 without injuries). The Shapiro–Wilk test, the Spearman’s rank correlation test, the Mann–Whitney U test and the Friedman’s ANOVA test were used. The level of significance was set at α = 0.05. The most important risk factors for eye complications in the study group were: lagophthalmos (p < 0.001), sedation (p < 0.01), use of some cardiological drugs and antibiotics (p < 0.01), mechanical ventilation (p < 0.05), use of an open suctioning system (p < 0.01), presence of injuries (p < 0.01) including craniofacial trauma (p < 0.001), high level of care intensity (p < 0.01), failure to follow eye care protocol (p < 0.001), length of hospitalization at the ICU (p < 0.001), and the frequency of ophthalmological consultations (p < 0.001). There was no correlation between the incidence of these complications and the age and gender of the patients. The exposure of critically ill patients to eye complications was high. It is necessary to disseminate protocols and guidelines for eye care in ICU patients to reduce the risk factors.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit

Płaszewska‐Żywko

Sega

Bukowa

et al. 2021

IJERPH

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“…All of these are situations may potentially lead to the conjunctival chemosis. Furthermore, This in line with (Bhala. et al, 2020) found that critical illness is frequently associated with capillary leak and fluid retention that causes peripheral edema and conjunctival edema and then may lead to inadequate eyelid closure.…”

Section: Reason For Admissionsupporting

confidence: 87%

Risk factors assessment of ocular surface disorders among adult critically ill patients

Ali

Mohamed²,

Mohamed³

et al. 2022

Assiut Scientific Nursing Journal

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Ocular complications are common in the critical care setting but are frequently missed due to the focus on life-saving organ support. In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. This study aims to: assess risk factors for ocular surface disorders among adult critically ill patients. Design: Exploratory research design. This study was carried in intensive care units at Assiut university hospital. Subjects: A convenience sampling of 60 adults patients. Tools: Two tools were utilized to collect data of study, tool I: Patient assessment sheet. Tool II: Risk factors assessment sheet. Method: The researcher assessed risk factors, eye lid closure and occurrence of ocular surface disorders. Results: The exposure of adult critically ill patients to ocular surface disorders was high related to right eye were 51% in 7 th day, related to left eye were 48% in 5 th day. Regarding type of abnormalities in right eye, the result revealed that 80.8% were mixed in 6 th day and 3.2% were corneal abrasion in7 th day. Conclusion: The study confirmed that important risk factors for ocular surface disorders in Intensive Care Unit (ICU) patients were: lagophthalmos, level of consciousness, mechanical ventilation, sedation and muscle relaxant, length of ICU stay, fluid misdistribution and respiratory microorganism. Recommendation: It is necessary to disseminate protocols and guidelines for eye care in ICU patients to reduce the risk.

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“…Zu den zusätzlichen Herausforderungen für die Augenheilkunde zählt nicht zuletzt auch die der Erweiterung der Intensivkapazitäten entsprechende vermehrte konsiliarische Betreuung von intensivmedizinisch behandelten bzw. beatmeten COVID-19-Patienten mit ophthalmologischen Komplikationen wie Lagophthalmus oder Optikusneuropathie [41].…”

Section: Auswirkungen Der Pandemie Auf Ophthalmologische Diagnostik Und Therapienunclassified

Ophthalmic Outpatient and Inpatient Care Under Pandemic Conditions: Hygiene, Triage and New Challenges

Hattenbach

Feltgen

Eter

et al. 2021

Klin Monbl Augenheilkd

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Background The progression of the COVID-19 pandemic has caused significant changes in the environment for outpatient and inpatient care in ophthalmology, with limitations on access to medical care but also new observations and challenges. We now describe major developments in recent months and provide an outlook on the expected consequences. Methods PubMed literature search, clinical survey. Results To date, the course of the COVID-19 pandemic has been characterised by several new but overall rare ocular manifestations, the ophthalmological shared management of COVID-19 patients on intensive care units, and a significant decrease in case numbers, associated with an increase in case severity and relative proportion of emergencies, as a result of delayed presentation of patients and reduced treatment adherence. With the introduction of hygiene measures and infection control procedures, ophthalmic patient care was maintained – including emergencies and urgent treatments. Due to the extensive postponement of elective surgeries, scarce therapeutic and health care professional resources, and the prioritisation of critically ill patients from other specialties, there is a reasonable likelihood that urgent treatments will be delayed as infection rates rise. Conclusion Outpatient and inpatient care in ophthalmology during the COVID-19 pandemic is primarily accompanied by additional organisational or medical challenges and a decline in case volume. Although to date emergency and urgent ophthalmic treatments have been maintained, long-term persistence of pandemic conditions will require additional strategies to provide continuation of ophthalmic care at the required level.

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COVID-19: The Role of the Ophthalmologist in ICU

Cited by 4 publications

References 6 publications

Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit

Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit

Risk factors assessment of ocular surface disorders among adult critically ill patients

Ophthalmic Outpatient and Inpatient Care Under Pandemic Conditions: Hygiene, Triage and New Challenges

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