Bedside Assessment of Ophthalmic Manifestations in Neurocritical Care: A Study in Tertiary Care Hospital

Background: This study aimed to investigate the incidence of Ocular Surface Disorders (OSDs)—including Dry Eye Disease, Chemosis, and Exposure Keratitis—among patients admitted to the Neurocritical Care Unit (NCC). The research also sought to assess the correlation between these disorders, the length of hospitalization in the NCC, and the Glasgow Coma Score (GCS). The heightened risk of developing OSDs in the NCC environment, particularly among patients with pre-existing neurological impairments, can lead to serious complications such as dry eye disease, chemosis, corneal abrasions, and infectious keratitis. These conditions can ultimately result in corneal opacities and perforations, significantly impacting visual acuity and overall quality of life. Methods: This observational cross-sectional study was conducted from February to May 2022, examining the ocular health of all patients admitted to the NCC unit. The study assessed the presence of conjunctivitis, chemosis, keratitis, and dry eyes in relation to various factors, including: Duration of stay in the NCC, Glasgow Coma Score (GCS), Lagophthalmos (inability to close the eyelids fully), Adherence to prescribed eye care protocols in the NCC, Use of mechanical ventilation A total of 100 subjects participated over the four-month period, with a mean age of 51.92 ± 18.73 years (age range: 17 to 89 years), including 70% males and 30% females (gender ratio of 2.33). Results: The study findings revealed the following incidences of ocular conditions: Conjunctival Hyperemia: 26 eyes (13%) Chemosis: 23 eyes (11.5%) Severe Dry Eye Disease: 41 eyes (20.5%) Statistically significant associations were observed between: GCS (p-value <0.001), Keratitis (p-value 0.0035), Dry Eyes (Chi-Square Test notably, the incidence of dry eyes was significantly higher among patients with a prolonged stay of ≥10 days (p-value 0.003). Conclusions: The study highlights the necessity for meticulous eye care and structured protocols in Neurocritical Care Units to mitigate the risk of long-term ocular complications, such as exposure keratitis. Given the increased susceptibility of NCC patients to these conditions, proactive measures are essential to ensure optimal ocular health and prevent serious visual impairments. Implementing standardized eye care practices can help enhance patient outcomes and preserve quality of life in this vulnerable population.