Exposure Keratopathy: Prophylaxis and Impact of Eye Care Education Programme in ICU Patients

Abstract

Introduction: Sedated and ventilated patients are more prone to develop exposure keratopathy. Eye care is gaining emphasis as a part of critical care for its prevention. Aim: To study the impact of education programme among ICU staff to prevent exposure keratopathy in Intensive Care Unit (ICU) patients at a tertiary care hospital. Materials and Methods: This prospective study was conducted on the patients admitted in Medicine, Surgical and Paediatric ICU at a tertiary care hospital. The medical staff were educated for the effects of sedation and ventilation on eyes. Patients were taken from all ICUs at different time periods before and after training. The pre training group consisted of 89 patients from October 2014 to February 2015 whereas the post training group had 57 patients from April 2015 to August 2015. Patients' demographic details along with lid position, conjunctiva and corneal examination were recorded and analysed. Results: The incidence of exposure keratopathy was 40% in total 146 patients included in the present study. The incidence of exposure keratopathy decreased from 44% to 33% after the eye care training given to the ICU staff. The maximum incidence of exposure keratopathy was found in Paediatric ICU i.e., 60%. The risk factors like lid position, conjuctival oedema, sedation level and poor outcome of patient were associated with the development of exposure keratopathy. Conclusion: The training given to the staff of ICUs reduced the incidence of exposure keratopathy by 10%. Thus the importance of an eye care algorithm is highlighted.

Keywords

• Intensive care unit
• Lagophthalmos
• Ocular surface disease