A prospective study of the incidence of iatrogenic ocular damage in critically ill patients

Introduction

Critically ill patients requiring intensive care are at risk of iatrogenic ocular damage. Studies have reported an incidence of eye problems of up to 40% in critically ill ventilated patients. We conducted this study to assess the incidence of ocular complications in our intensive care unit where all patients arc cared for according to an eye care standard.

Methods

All ventilated patients over a 2 month period were included. Ophthalmic assessment was performed on admission and repeated every other day during the period of ventilation. At each assessment the average Ramsey sedation score over the previous 24 h, the presence of tracheal secretions and the presence of ventilation associated pneumonia was noted. Eye care performed was recorded.

Results

Sixty patients were included. One patient developed corneal exposure keratopathy. No patient developed conjunctivitis or corneal ulceration. Further advice on appropriate measures of eye care was given in five cases (8%). Nine patients (15%) had large amounts of respiratory secretions with positive microbiological results.

Conclusion

This study confirms that the use of an eye care standard is associated with a low incidence of ocular surface complications. The incidence of ocular complications in this group of patients is far lower than previously described.