Eyecare in the critically ill: Clinical practice guideline

Fatores de risco para lesão de córnea em pacientes criticos na terapia intensiva: uma revisão integrativa Risk factors for injury in the cornea in critical patients in intensive care: an integrative review

“…13,17 It was observed, so, that the muscular relaxation promoted by the action of neuromuscular blocking causes the decrease of the tonus of the eyelid which favors the incomplete closure. 6,16,18,20 The lowering of the low score evidenced awareness level on the Glasgow Coma Scale is identified in several studies as a risk factor that contributes significantly to the development of the injury, since patients with neurological deficits have their natural reflexes and protection mechanisms committed. The respiratory tract infection associated with prolonged use of mechanical ventilation settles frequently in these patients so that bacterial translocation respiratory tract eyewear during tracheal aspiration without eye protection patient was identified as an aggravating factor, because in many cases there are accidental spills of tracheal aspirates during the procedure.…”

“…5,14,16 Therefore, also, it was highlighted that conscious patients with disturbed sleep pattern and who have trouble sleeping in the intensive care unit are predisposed to prolonged eye opening and risk of abrasion and eye dryness. 6 Some authors report that some metabolic disorders are involved in eye injury process. The failure of vital organs in critically ill patients involves the use of vasoactive drugs and medicines to stabilize the clinical picture.…”

“…The failure of vital organs in critically ill patients involves the use of vasoactive drugs and medicines to stabilize the clinical picture. [5][6] Some medications decrease the production and secretion of the tear film and therefore at high risk for corneal injury as Antihistamines, atropine, phenothiazines and tricyclic antidepressants. 16 The length of stay in the intensive care unit constitutes another factor of extreme relevance.…”

“…4 Studies show that due to the high technology linked to the practice of care, procedures considered of low complexity, such as hygiene and eye protection, are neglected in the context of intensive care, predisposing the patient to risk of ophthalmic adverse events. 5,6 Patients with serious medical conditions are at high risk of eye injury, characterized as an inflammatory or infectious process that occurs from surface layers to the deepest of the eyeball through the commitment of its natural protective mechanisms. 7 Production of the tear film, corneal reflex eyelid and eyelid closure are reduced or even abolished in these patients, which makes the cornea -the outer layer, avascular and surface of the eye -exposed to factors that promote its dryness facilitating the development of lesions, which in severe cases lead to ulceration.…”

Dry eye in critically ill patients: integrative review Olho seco em pacientes críticos: revisão integrativa

“…4 The risk factors for dry eye, indicated by 50% or more of the analyzed studies were lagophthalmos (85.18%), 3,[5][6][7][8]16,[25][26][27][28][29][30][31] sedatives (70.37%), 1,[3][4][5][6]8,10,16,26,29,31,33, MV (66.66%), 1,[3][4][5][6][7][8]10,16,24,26,29,33, , and muscle relaxants (55.55%). 1,[3][4][5][6][7][8]10,27,29,31, Lagophthalmos is described as the incomplete or inadequate eyelid closure and is diagnosed when part of the conjunctiva or cornea is visible. …”