Eye care in the intensive care unit

Hearne, Benjamin J; Hearne, Elewys G; Montgomery, Hugh; Lightman, Susan

doi:10.1177/1751143718764529

Cited by 59 publications

(73 citation statements)

References 14 publications

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“…Our patients, like many critically ill patients, are prone to fluid and electrolytes imbalance, which makes them prone to conjunctival edema and impair eyelid closure [8]. Conditions such as hypoalbuminemia and fluid overload associated with generalized edema are risk factors for conjunctival chemosis [12]. In addition, states of increased hydrostatic pressure such as prone ventilation or prolonged recumbency predispose patients to conjunctival chemosis [12].…”

Section: Discussionmentioning

confidence: 99%

“…Conditions such as hypoalbuminemia and fluid overload associated with generalized edema are risk factors for conjunctival chemosis [12]. In addition, states of increased hydrostatic pressure such as prone ventilation or prolonged recumbency predispose patients to conjunctival chemosis [12]. Conjunctival chemosis can also occur as a complication of eye surgery such as canthal surgery [3,4].…”

Section: Discussionmentioning

confidence: 99%

“…Critically ill patients are prone to loss of blinking reflexes, which can cause clinically significant eyelid edema by interfering with eyelid closure [12]. Sedated patients have impaired blinking reflexes, which result in significant loss of protective eye movements and lubrication [6,8].…”

Section: Discussionmentioning

confidence: 99%

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An Unusual Case of Bilateral Hemorrhagic Chemosis in the Intensive Care Unit

Ajibawo¹,

Zahid²,

Leykind³

2020

Cureus

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Critically ill patients cannot complain about eye problems. Eyecare is often overlooked in the intensive care units (ICUs) because treatment is mainly focused on failures of organ which results in eye complications which are preventable. Therefore, we report a case of a patient admitted to the ICU who developed unusual bilateral hemorrhagic chemosis. Although, chemosis has been encountered often in the ICU, hemorrhagic chemosis without prior direct trauma is unusual.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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An Unusual Case of Bilateral Hemorrhagic Chemosis in the Intensive Care Unit

Ajibawo¹,

Zahid²,

Leykind³

2020

Cureus

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“…3,4 Ocular surface disorders (OSDs) affect 23-60% of ICU patients. 1 Lagophthalmos is considered as the defective or incomplete closure of the eyelids. 5 Lagophthalmos disables the first protective mechanism of the eyes of these patients, which may predispose them to eye dryness and corneal epithelial breakdown.…”

Section: Introductionmentioning

confidence: 99%

“…This needs to be applied correctly into the eye. 1 Despite all reported clinical trials, the high prevalence of ocular complications among ICU patients still remains an issue. Hence, there is a need to develop new protocols to minimize the consequences of eye dryness among these patients.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of lubratex and vitamin A on ocular surface disorders in ICU patients: A randomized clinical trial

Badparva

Veshagh

Khosravi

et al. 2020

Journal of the Intensive Care Society

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Background High prevalence of ocular surface disorders includes eye dryness and corneal ulcer among intensive care unit patients remains an issue. This study aimed to compare the effectiveness of Lubratex ointment and vitamin A eye ointment in preventing ocular surface disorders in intensive care unit patients. Methods A single-center randomized clinical trial was conducted in critically ill patients of vitamin A eye ointment and Lubratex ointment in preventing ocular surface disorders. Forty-one eligible patients were randomly assigned to administered vitamin A eye ointment in one eye and Lubratex ointment in the other eye. After five days, using fluorescein and Schirmer's tests, an ophthalmologist examined patients and specified those with ocular surface disorders. Results The results showed a significant decrease in the incidence of dry eye ( p ≤ 0.001) and corneal ulcer ( p = 0.002) with the use of Lubratex ointment. Conclusions Although Lubratex ointment was more effective than vitamin A ointment in preventing ocular surface disorders, further research is needed to confirm the findings of the present study.

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Conjunctival Findings in Patients With Coronavirus Disease 2019

2021

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To the Editor We read with interest the article by Wu et al 1 on ocular findings in coronavirus disease 2019 . We wish to understand more about the study in the following aspects.First, the authors reported conjunctivitis in 12 of 38 patients with COVID-19 in a consecutive case series. Notably, the prevalence of conjunctival congestion was merely 0.8% (9 of 1099 patients) in another larger study from China. 2 Could the authors clarify if they are implying that the conjunctivitis was associated with COVID-19 affecting the conjunctiva (ie, viral conjunctivitis) or nonspecific signs from conjunctival congestion or chemosis from COVID-19's systemic manifestations, 3 intensive care, 4 or other benign causes (eg, dry eyes, conjunctival irritation)?Second, 2 patients had positive conjunctival swab results, with each having different ocular manifestations. What do the authors hypothesize are the infective mechanisms? For example, could it be direct conjunctival invasion or infection via nasopharyngeal secretions?Third, could the authors provide detailed clinical features of suspected cases? Do they have any clinical photographs? Also, how were the assessments performed, and what instruments were used to assess the conjunctivitis (eg, slitlamp biomicroscopy, portable slitlamp, or handheld flashlight)? The authors reported 4 features: epiphora, chemosis, hyperemia, and secretions. However, each was used in isolation to diagnose conjunctivitis, which may not be specific. Could the authors indicate if there were supportive features, such as subjective complaints (itch and pain), the character of the discharge, and any papillary or follicular reaction of the palpebral conjunctiva?Lastly, could the authors provide more about the course and outcome of the reported cases of conjunctivitis? What treatments were used? Were there any ophthalmic sequelae, such as corneal, episcleral, or scleral involvement? We thank the authors for considering these clarifications and providing some additional information.

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Eye care in the intensive care unit

Cited by 59 publications

References 14 publications

An Unusual Case of Bilateral Hemorrhagic Chemosis in the Intensive Care Unit

An Unusual Case of Bilateral Hemorrhagic Chemosis in the Intensive Care Unit

Effectiveness of lubratex and vitamin A on ocular surface disorders in ICU patients: A randomized clinical trial

Conjunctival Findings in Patients With Coronavirus Disease 2019

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