Risk for corneal injury in intensive care unit patients: A cohort study

Abstract Aim To identify the incidence and risk factors for corneal injury amongst critically ill patients. Method A prospective cohort study with adult patients from one intensive care unit in Northern Brazil. Logistic regression was performed to predict the risk factors associated with corneal injury. Results Data from 149 patients revealed 18.8% (28/149) corneal injuries. Factors independently associated with corneal injury were patients with eyeball exposure (OR: 27.31; 95% CI: 3.50–212.78); lagophthalmos (OR: 17.15; 95% CI: 5.78–50.85); chemosis (OR: 7.39; 95% CI: 2.28–23.97), periorbital oedema (OR: 7.99; 95% CI: 2.19–29.13) and hospitalisation >7-days (OR: 11.96; 95% CI: 3.27–43.66) had a significantly higher risk of developing corneal injury in this ICU. Conclusion Corneal injury was a common complication amongst critically ill patients and was associated with altered physiological function of the eyes such as exposure, lagophthalmos, chemosis and periorbital oedema. This study suggests introduction of a corneal injury prevention protocol for nursing and adding lagophthalmos and chemosis to the NANDA-I Taxonomy, thus contributing to the assessment and monitoring for the risk for corneal injury in critically ill patients.