Nurses can play an active role in the early diagnosis of exposure keratopathy in intensive care patients

Jpn J Nurs Sci. 2018 Jan;15(1):31-38. doi: 10.1111/jjns.12165. Epub 2017 Feb 7.

Abstract

Aim: This study was conducted in order to determine nurses' ability to diagnose exposure keratopathy reliably in the early stage in intensive care patients.

Methods: This methodological and descriptive study was carried out between 2011 and 2012 in the Neurology and Anesthesiology and Reanimation Intensive Care Units of a teaching hospital in western Turkey. The sample consisted of 4354 ocular assessments in 156 corneas of 78 patients. A patient identification form and a fluorescein test patient tracking chart were used in the data collection. The corneas of the patients were checked by a fluorescein dye test by the same nurse and ophthalmologist.

Results: The mean age of the patients was 59 ± 15.5 years and 47.4% of them were female. The consistency between the nurse and the ophthalmologist was almost perfect in terms of determining the presence of exposure keratopathy, characteristics, and the grade of corneal staining. Exposure keratopathy was detected at a rate of 2% by the ophthalmologist. A significant relationship was found between the presence of lagophthalmos and the development of exposure keratopathy. A positive correlation was found between the grade of corneal staining and the degree of the eyelid position of the patients and the duration of mechanical ventilation therapy.

Conclusion: After eye care and assessment training, intensive care nurses can play an effective role in detecting early-stage exposure keratopathy in intensive care patients.

Keywords: corneal assessment; early diagnosis; exposure keratopathy; intensive care unit; nursing practice.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Corneal Diseases / diagnosis*
  • Critical Care
  • Early Diagnosis*
  • Female
  • Fluorescein / administration & dosage
  • Fluorescent Dyes / administration & dosage
  • Hospitals, Teaching
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Nursing Diagnosis*
  • Reproducibility of Results
  • Respiration, Artificial
  • Turkey
  • Young Adult

Substances

  • Fluorescent Dyes
  • Fluorescein