Table 3

Revised guidelines for the ocular care of unconscious patients

Eye care recommendations
1Unconscious patients with no ocular infection should have eye care 2 hourly
2The eyes should be regularly inspected for lid swelling, conjunctival hyperaemia, corneal clouding, or epithelial loss
3If there is corneal exposure lubricating ointment should be applied to the eyes 2 hourly
4Patients at risk of corneal exposure should have their lids mechanically apposed with adhesive tape
5Tracheal suctioning should take place from the side of the bed with the eyes covered
6Daily conjunctival swabs should be taken if there is a positive respiratory isolate of Pseudomonas aeruginosa. An urgent conjunctival Gram stain should be performed if there is a clinical suspicion of ocular infection
7Topical gentamicin should be started if pseudomonas is isolated from the conjunctiva and an ophthalmic opinion sought