An audit of eye dryness and corneal abrasion in ICU patients in Iran

Background: The use of sedation and muscle relaxants can predispose intensive care unit (ICU) patients to poor eyelid closure and eye disorders. These complications may not get the nursing care and attention that they require; this and the predisposing factors need to be further investigated. Aims and objectives: The aim of this audit was to use the standard eye-care technique and determine the incidence of eye dryness and corneal abrasion, on day 5 after admission, in comatose patients in the ICU. Design and methods: This was an audit, in the four ICUs in two teaching hospitals in the cities of Kashan and Tehran. An ophthalmologist examined the corneal abrasion and eye dryness on the day of admission and then day 5. The eye-care method and other variables such as sex and age were also recorded. Statistical tests of �2, spearman and multiple linear regressions were used to determine the relationships between variables. Results: Eighty-seven patients participated in the audit. On day 5, 28 patients (32·2) had dry eyes and 12 patients had developed corneal abrasion (13·8). The mean of Schirmer tear value on admission was 21±4·5mm. This value decreased to 16·1±5·6mm on day 5. About 10·3 of patients who received eye lubricant products, and 20·7 of those receiving adhesive tape as eye-care method developed corneal abrasion. Conclusions: Corneal abrasion and eye dryness were common problems in ICU patients. Eye dryness was the main risk factor for the development of corneal abrasion. Patients receiving adhesive tape as an eye-care method were twice more likely to develop corneal abrasion. Relevance to clinical practice: Eye care and eye assessment should be essential parts of nursing care for patients in ICU. To prevent corneal abrasion, using eye lubricants is more effective than closing eyes by adhesive tape. © 2013 British Association of Critical Care Nurses