Incidence and risk factor evaluation of exposure keratopathy in critically ill patients: A cohort study

Kuruvilla, Shilpa; Peter, Jayanthi; David, Sachin; Premkumar, Prasanna Samuel; Ramakrishna, Kartik; Thomas, Lovely; Vedakumar, Manuel; Peter, John Victor

doi:10.1016/j.jcrc.2014.10.009

Cited by 54 publications

(72 citation statements)

References 17 publications

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“…Incomplete eyelid closure is one of the main indicators with potential to trigger eye disorders, due to total or partial exposure of the eye surface and consequent excessive tear evaporation ( 14 ) . In this study, if evaluated individually, it was found that the incomplete eyelid closure was absent (score 5) in most of the sample (81.1%).…”

Section: Discussionmentioning

confidence: 99%

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Clinical indicators of dry eye severity nursing outcome in intensive care unit

Soares

Fernandes

Botarelli

et al. 2019

Rev. Latino-Am. Enfermagem

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Objective:to verify the extent of impairment of the clinical indicators of the nursing outcome Dry Eye Severity in patients admitted to the Intensive Care Unit.Method:cross-sectional, descriptive study developed with 206 patients. Based on the result listed, six indicators of the Classification of Nursing Results were evaluated with a questionnaire containing clinical variables and the Likert scale of the Classification of Nursing Results with constructed definitions, which varies from more impaired to non-impaired. The data were analyzed using descriptive and inferential statistics.Results:the decrease in lacrimal production and the presence of redness in the conjunctiva were more impaired. The other indicators were more frequent for the absence of impairment: incomplete eyelid closure 81% (167), excessive tearing 95.1%(196), excessive mucous secretion 78.7% (162) and decreased blinking mechanism 50.5% (104). The clinical characteristics of hospitalization for neurological disorders, invasive mechanical ventilation, chemosis, use of sedatives, vasoconstrictors, benzodiazepines, antibiotics and corticosteroids interfered in the impairment of the dry eye severity.Conclusion:the result indicators show that the clinical characteristics of patients in the intensive care unit interfere in the impairment and in the dry eyes severity. According to these results, the importance of assistance directed to the prevention of eye diseases is emphasized.

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Section: Discussionmentioning

confidence: 99%

“…A recent study revealed that on the first day of ICU stay, 86.3% of patients had total eyelid closure in the right eye and 85.3% in the left eye, however, after one week of using sedatives, 20.3% evolved with incomplete eyelid closure in the right eye and 24.3% in the left (increased involvement in 6.6% and 9.6%, respectively) ( 14 ) .…”

Section: Discussionmentioning

confidence: 99%

Clinical indicators of dry eye severity nursing outcome in intensive care unit

Soares

Fernandes

Botarelli

et al. 2019

Rev. Latino-Am. Enfermagem

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“…Defense mechanisms of the eye are destroyed when treatments, such as mechanical ventilation, sedation, and neuromuscular blockage, are added to factors such as metabolic disorders, multiple organ failure, and unconsciousness in intensive care unit (ICU) patients. Ocular problems that start with lagophthalmos (the inability to fully close the eyelids) can lead to corneal abrasion, chemosis (conjunctival edema), exposure keratopathy, dry eye syndrome, and irreversible microbial keratitis (Grixti, Sadri, Edgar, & Datta, ; Güler, Eşer, & Fashafsheh, ; Kousha, Kousha, & Paddle, ; Kuruvilla et al , ; Saritaş et al , ).…”

Section: Introductionmentioning

confidence: 99%

“…Mild cases are managed easily, but if they are severe, undetected, and/or undertreated, serious consequences can occur. Corneal dryness is more likely to go undiagnosed or uncured in ICU patients when other medical problems are being focused on (Kuruvilla et al , ; Oliveira et al , ; Werli‐Alvarenga, Ercole, Botoni, Oliveira, & Chianca, ).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, McHugh et al reported that 70% of the patients with lagophthalmos had exposure keratopathy. As a result of recent research, it has been determined that exposure keratopathy developed in 13.2% of the patients ( n = 301) in the ICU at an average of 4.6 ± 2.6 days after they were hospitalized and the prevalence of this disorder was ascertained as 27.3% (Kuruvilla et al , ). These percentages suggest that eye problems in ICU patients have to be taken into consideration.…”

Section: Introductionmentioning

confidence: 99%

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Nurses can play an active role in the early diagnosis of exposure keratopathy in intensive care patients

Güler

Eşer

Eğrilmez

2017

Japan Journal Nursing Sci

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Aim: This study was conducted in order to determine nurses' ability to diagnose exposure keratopathy reliably in the early stage in intensive care patients. Methods: This methodological and descriptive study was carried out between 2011 and 2012 in the Neurology and Anesthesiology and Reanimation Intensive Care Units of a teaching hospital in western Turkey. The sample consisted of 4354 ocular assessments in 156 corneas of 78 patients. A patient identification form and a fluorescein test patient tracking chart were used in the data collection. The corneas of the patients were checked by a fluorescein dye test by the same nurse and ophthalmologist. Results: The mean age of the patients was 59 AE 15.5 years and 47.4% of them were female. The consistency between the nurse and the ophthalmologist was almost perfect in terms of determining the presence of exposure keratopathy, characteristics, and the grade of corneal staining. Exposure keratopathy was detected at a rate of 2% by the ophthalmologist. A significant relationship was found between the presence of lagophthalmos and the development of exposure keratopathy. A positive correlation was found between the grade of corneal staining and the degree of the eyelid position of the patients and the duration of mechanical ventilation therapy. Conclusion: After eye care and assessment training, intensive care nurses can play an effective role in detecting early-stage exposure keratopathy in intensive care patients.

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Part I: Anesthesia and ventilator management in critical care patients

Patel¹,

Muir²

2021

J Am Coll Clin Pharm

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Incidence and risk factor evaluation of exposure keratopathy in critically ill patients: A cohort study

Cited by 54 publications

References 17 publications

Clinical indicators of dry eye severity nursing outcome in intensive care unit

Clinical indicators of dry eye severity nursing outcome in intensive care unit

Nurses can play an active role in the early diagnosis of exposure keratopathy in intensive care patients

Part I: Anesthesia and ventilator management in critical care patients

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