Eye Care Practice in Intensive Care Units: A Rapid Review
Bibliographic record
Abstract
Introduction. Ocular Surface Diseases (OSDs) are frequent yet often under-recognised complications in sedated and mechanically ventilated Intensive Care Unit (ICU) patients, in whom impaired eyelid closure and reduced tear film protection promote their development during critical illness. Although these conditions can significantly affect visual function and post-discharge quality of life, ocular care receives inconsistent attention in routine clinical practice. This rapid review aimed to identify and synthesise evidence-based nursing practices for the prevention and management of OSDs in the ICU within this patient population. Methods. A rapid review was conducted between February and August 2024 and registered in PROSPERO (CRD42024540825). Searches were carried out in MEDLINE, CINAHL, Embase, and Google Scholar for full-text studies published in English between 2014 and 2024 that involved adult ICU patients receiving nurse-delivered ocular interventions. Methodological quality was appraised using the Joanna Briggs Institute critical appraisal tools. Given the heterogeneity of study designs and outcomes, a narrative synthesis was undertaken. Results. Fourteen studies (n = 1,322 patients) from six countries met the inclusion criteria; most were randomised controlled trials (64%), and 72% were rated as having high methodological quality. Interventions included the application of preservative-free lubricants, vitamin A–based ointments, moisture chambers, polyethylene covers, eyelid taping, and structured nurse-led protocols. Moisture chambers and ointments demonstrated the strongest protective effects against exposure keratopathy, while the implementation of protocols and targeted nurse education significantly reduced ocular morbidity. Discussion. The findings reaffirm the central role of ICU nurses in preventing OSDs through timely, evidence-based interventions. Standardising eye care practices may substantially reduce complications and enhance long-term visual outcomes. Further high-quality multicentre studies are required to refine recommendations and support broader clinical implementation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.043 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.005 |
| Bibliometrics | 0.015 | 0.018 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".