Ocular complications of COVID-19 patients in intensive care

Abstract

Introduction: Admission to Intensive Care Units exponentially increased during the Covid-19 pandemic. The emphasis on life-saving organ support, which includes mechanical ventilation, prone positioning, ECMO, sedation, and neuromuscular blockade, raises the risk of developing ocular complications in these severely ill patients. As a result, we propose to describe the ocular complications in COVID-19 patients admitted to an ICU in a tertiary hospital in order to educate about eye care and preventive steps to maintain the quality of life for COVID-19 patients. Methods: An observational retrospective study was conducted based on the survey review of electronic medical records (SClínico) of every consecutive patient diagnosed with COVID-19 admitted to the ICU of the tertiary hospital Centro Hospitalar Universitário de São João, Porto, Portugal, during the years of 2020 and 2021, with the onset of ocular complications signs and in which an evaluation from the ophthalmology department was requested. Results: A total of 24 of 253 COVID-19 patients admitted to the ICU, developed ocular complications. We describe 6 (25.0%) cases of exposure keratopathy, 5 (20.1%) cases of conjunctivitis and 9 (37.5%) cases of conjunctival hemorrhages. The remaining four were individual cases of eyelid ulcer, mucormycosis, necrotizing scleritis and globe rupture (4.2% each). Conclusion: This study outlines the variety of ophthalmic complications encountered in a critical care setting in COVID patients, ranging from treatable ocular surface diseases to irreversible complications with lifelong vision loss and blindness. As a result, educate about eye care and preventive steps must be a priority to maintain the quality of life for COVID-19 patients.