Purpose. The intensive care unit can be a hostile environment for patients whose ocular defense mechanisms are impaired. This often presents a challenge for the consulting ophthalmologist. Metabolic derangement, artificial respirators, immunological dysfunction, impaired mental status, and facial injuries can leave a patient vulnerable to numerous ophthalmological catastrophes. This study was undertaken to identify clinical factors mat are associated with an increased incidence of corneal abnormalities and the overall prevalence of keratopathy in a randomly selected group of intensive care unit patients at the University of California, Davis Medical Center. Methods. Fifty intensive care unit patients were examined with a portable slit-lamp. Any evidence of superficial keratopathy was documented. Associated factors analyzed included: 1) Glascow Coma Scale, 2) period in the intensive care unit, 3) intubation status, 4) underlying disease, and 5) current eye care. Results. Superficial keratopathy was present in 40% of the 50 patients examined. Ninety percent of these affected patients were intubated, 70% were residents of intensive care unit for ≥ 7 days, and 60% had a Glascow Coma Scale of ≤ 7. Only one patient was receiving ocular lubrication at the time of examination. Conclusion . The prevalence of corneal abnormalities in the critically ill patient reflects certain predictors of keratopathy including Glascow Coma Scale, length of hospitalization, intubation, and significant metabolic derangement. In keeping with the evolving practice of preventive care, more ophthalmologic attention must be given to the intensive care unit patient upon admission. Lubricants, patching at night, and moisture chambers are measures that can be instituted on admission orders, possibly preventing future ocular disease.
|Original language||English (US)|
|Journal||Investigative Ophthalmology and Visual Science|
|State||Published - Feb 15 1996|
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