Dry Eye Syndrome in Intensive Care Units: a concept analysis

Abstract

Purpose: To analyse the concept of Dry Eye Syndrome in patients admitted to Intensive Care Units (ICU). Method: This is a concept analysis, according to Walker’s and Avant’s method, conducted using an integrative review, through search in the database. Science Direct, Scopus, Cinahl, Pubmed, Lilacs, Cochrane and Web of Science. The following keywords were used: “Keratoconjuntivite Sicca”, “Risk Factors”, “Dry eye Syndromes” and “Intensive Care Units”. After selection, 85 articles have been kept. Results: Antecedents found: age, lagophthalmos, environmental factors, use of medications, systemic diseases, mechanical ventilation and eye surgeries. Attributes: Tear Break-up Time < 10 s, Schirmer’s test I < 10 mm, Schirmer’s test II < 5 mm and signs and symptoms. Consequents: eye damage and discomfort; unstable vision. The Model Case and the Contrary Case were used to illustrate it. Conclusion: The research provided clarification of the concept and consequent understanding of the Dry Eye Syndrome, which is preventable especially in ICU.

Validation of nursing outcome indicators of the nursing outcomes classification: dry eye severity

“…The Eyestrain indicator consists of inadequate visualization of objects at the end of the day caused by strain on the visual system. Other studies also report eyestrain as one of the frequent symptoms in patients with dry eye (11,25) . We highlight that this indicator was included in the NO Dry Eye Severity from a previous concept analysis study (11) .…”

“…The blinking mechanism indicator refers to the opening and closing movements of the eyelid. The proposal to include this indicator in this study also occurred after a concept analysis proposed to identify the indicators for the NO Dry Eye Severity in patients admitted to ICU (11) . Another study developed in patients with the nursing diagnosis Risk of ocular dryness pointed out that individuals with spontaneous blink reflex greater than five times per minute have a 40% lower risk of having dry eye than patients with an absent or reduced reflex (3) .…”

“…The indicators and the constitutive definitions, operational and operational magnitude of the nursing outcome, Dry eye Severity of the Nursing Outcomes Classification (6) were built in a previous study based on a concept analysis (11) .…”

Fatores clínicos preditores para o ressecamento ocular em pacientes internados na Unidade de Terapia Intensiva

“…Intensive Care Unit (ICU) patients are treated with specific therapies, present critical clinical situations and require multiple medications, ventilatory support and other equipment to maintain vital parameters, which predispose them to developing ocular dryness, dry eye and which may progress to vision loss (1)(2)(3) .…”

“…Such conditions are characterized by a loss of homeostasis of the tear film triggered by dryness of the ocular surface, which is evidenced by ocular signs and symptoms such as burning, foreign body sensation, photophobia, hyperemia and visual acuity disorders. Therefore, the instability and hyperosmolarity of the tear film, inflammation and ocular surface damage, and neurosensorial abnormalities exert etiological functions (2)(3)(4)8) .…”