Intensive Care Nursing/Essential Nursing Cares (eye)

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Eye Care

The potential for damage to the eyes is a recognised risk for the ICU patient due to sedation and paralysing agents, reduced or absent blinking, infection and the environment. Rosenberg (2008) state that 20-42% of ICU patients develop exposure keratopathy.

To start, take a look at these resourcesː

• |The Eye

• How The Eye Works

Eye Assessment

Part of routine practice as part of initial thorough assessment at the start of each shift. Assess forː

• Eye & eyelid general cleanliness
• Signs of infection or red eyes (Viral or bacterial conjunctivitis)
• Risk factors for Ocular Surface Disorder (OSD)
• Keratopathy (corneal damage)
• Corneal dryness, discolouration or ulceration
• Lagopthalmus (incomplete eye closure) Wikipedia:Lagophthalmos
• Ocular surface disorder
• Conjunctival Oedema (Chemosis)

Eye care interventions

• Sterile technique
• Saline soaked gauze (some ICU’s may use sterile water) to clean. This is also known as “eye toilet”.
• Patient sedation level:

   Sedated patient- eye lubricant (also may add moisture chamber with polyethene film)
   Awake patient- Artificial tears 

Resources

Johnson,K. & Rolls, K. (2013). Eye Care for Critically Ill Adults. NSW Agency for Clinical Innovation Intensive Care Coordination and Monitoring Unit (Poster)

Johnson,K. & Rolls, K. (2013). Eye Care for Critically Ill Adults. NSW Agency for Clinical Innovation Intensive Care Coordination and Monitoring Unit (Guideline)

Kam et al (2013) Eye Care in the Critically Ill: A National Survey and Protocol

Rosenberg, J. B., & Eisen, L. A. (2008). Eye care in the intensive care unit: narrative review and meta-analysis. Critical care medicine, 36(12), 3151-3155.

Intensive Care Society (2017). Eye care in the intensive care unit (ICU)