Ocular Complications in the Prone Position in the Critical Care Setting: The COVID-19 Pandemic. (March 2021)

• Record Type: Journal Article
• Authors: Sanghi, Priyanka; Malik, Mohsan; Hossain, Ibtesham T.; Manzouri, Bita
• Is Part Of: Journal of intensive care medicine. Volume 36:Number 3(2021)
• Page Start: 361
• Page End: 372
• Publication Date: 2021-03
• Subjects: prone positioning -- ocular complications -- eye care -- COVID-19 -- critical care -- eye disorders; Critical care medicine -- Periodicals; Critical Care -- Periodicals; Soins intensifs -- Périodiques; Soins intensifs; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.02805
• DOI: 10.1177/0885066620959031
• Languages: English
• ISSNs: 0885-0666

Abstract

Purpose: Ocular complications are common in the critical care setting but are frequently missed due to the focus on life-saving organ support. The SARS-CoV-2 (COVID-19) pandemic has led to a surge in critical care capacity and prone positioning practices which may increase the risk of ocular complications. This article aims to review all ocular complications associated with prone positioning, with a focus on challenges posed by COVID-19. Materials and Methods: A literature review using keywords of "intensive care", "critical care", "eye care", "ocular disorders", "ophthalmic complications, " "coronavirus", "COVID-19, " "prone" and "proning" was performed using the electronic databases of PUBMED, EMBASE and CINAHL. Results: The effects of prone positioning on improving respiratory outcomes in critically unwell patients are well established; however, there is a lack of literature regarding the effects of prone positioning on ocular complications in the critical care setting. Sight-threatening ophthalmic disorders potentiated by proning include ocular surface disease, acute angle closure, ischemic optic neuropathy, orbital compartment syndrome and vascular occlusions. Conclusions: COVID-19 patients may be more susceptible to ocular complications with increased proning practices and increasing demand on critical care staff. This review outlines these ocular complications with a focus on preventative and treatment measures to avoid devastating visual outcomes for the patient.