{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:19:00Z","timestamp":1787750340534,"version":"build-2784847793"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract<\/jats:title>\n \n Background and Aims:<\/jats:title>\n Patients on prolonged mechanical ventilation are at risk of exposure keratopathy and conjunctival microbial colonization. This study aimed to evaluate the incidence of exposure keratopathy and the pattern of conjunctival microbial flora in mechanically ventilated ICU patients.<\/jats:p>\n <\/jats:sec>\n \n Material and Methods:<\/jats:title>\n Ocular evaluation for the presence of EK using fluorescein dye and grading was done in patients on mechanical ventilation in ICUs. Conjunctival swabs from these patients were analyzed for culture and sensitivity on day 3 and day 7. Regular follow-up was done.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 52 patients were included with a mean age of 51.57 \u00b1 16.65 years, with sepsis (28%) as the most common cause for admission. 32% of patients had EK, and the most common organisms found in different grades of EK were\n Staphylococcus haemolyticus<\/jats:italic>\n in grade 1,\n Acinetobacter baumanni<\/jats:italic>\n i in grade 2, and\n Pseudomonas aeruginosa<\/jats:italic>\n in grade 3. The most common commensal found in our study was\n Staphylococcus epidermidis<\/jats:italic>\n (52%), and the noncommensal was\n Staphylococcus aureus<\/jats:italic>\n (11%).\n Pseudomonas aeruginosa<\/jats:italic>\n and\n Candida albicans<\/jats:italic>\n were found to be present only on day 7 of the ICU care. Conjunctival culture yielded the same organism as in the endotracheal tube culture result in 13.5% of the cases.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Eye care in critically ill patients on mechanical ventilation is often ignored, and it can lead to rare but potentially devastating complications such as corneal perforation and endophthalmitis, which have long-term consequences on a patient\u2019s quality of life. Hence, it is essential to monitor eye care, assess EK, and manage at the earliest with a standard eye care protocol for mechanically ventilated ICU patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/joacp.joacp_59_25","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T13:05:47Z","timestamp":1782306347000},"page":"412-416","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Exposure keratopathy and conjunctival microbial flora in mechanically ventilated patients \u2013 A hospital-based prospective study"],"prefix":"10.4103","volume":"42","author":[{"given":"M Bindu","family":"Malini","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Department of Anesthesiology, JSS Medical College, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H M","family":"Akshay","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Department of Anesthesiology, JSS Medical College, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya","family":"Nataraj","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Department of Anesthesiology, JSS Medical College, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreyanka","family":"Mane","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Department of Anesthesiology, JSS Medical College, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keerthi K.","family":"Pullukkil","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Department of Anesthesiology, JSS Medical College, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. S","family":"Vasan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Department of Anesthesiology, JSS Medical College, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"R1-20260626","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1177\/0310057X1003800129","article-title":"Ocular surface bacterial colonisation in sedated intensive care unit patients","volume":"38","author":"Mela","year":"2010","journal-title":"Anaesth Intensive Care"},{"key":"R2-20260626","doi-asserted-by":"crossref","first-page":"e2061","DOI":"10.1002\/nop2.2061","article-title":"Prevalence and risk factors of exposure keratopathy among critically ill patients: A systematic review and meta-analysis","volume":"11","author":"Chen","year":"2024","journal-title":"Nurs Open"},{"key":"R3-20260626","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.jcrc.2017.11.031","article-title":"Exposure keratopathy: Incidence, risk factors and impact of protocolised care on exposure keratopathy in critically ill adults","volume":"44","author":"Kousha","year":"2018","journal-title":"J Crit Care"},{"key":"R4-20260626","doi-asserted-by":"crossref","DOI":"10.5772\/intechopen.112345","article-title":"Prevention of Corneal Injury in Critically Ill Sedated and Mechanically Ventilated Patients: Theoretical and Evidence-Based Practice","author":"do Prado","year":"2024","journal-title":"Keratitis-Current Perspectives. IntechOpen"},{"key":"R5-20260626","first-page":"343","article-title":"Ocular surface disorders in the critically III","volume":"85","author":"Imanaka","year":"1997","journal-title":"Anesth Analg"},{"key":"R6-20260626","doi-asserted-by":"crossref","first-page":"633","DOI":"10.18410\/jebmh\/2021\/124","article-title":"A clinical study on ocular surface disorders in intensive care unit patients at SVRRGGH, Tirupati-A hospital based descriptive cross-sectional study","volume":"8","author":"Bukke","year":"2021","journal-title":"J Evid Based Med Healthc"},{"key":"R7-20260626","doi-asserted-by":"crossref","first-page":"3077","DOI":"10.4103\/ijo.IJO_3017_21","article-title":"Lagophthalmos: An etiological lookout to frame the decision for management","volume":"70","author":"Rita","year":"2022","journal-title":"Indian J Ophthalmol"},{"key":"R8-20260626","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1177\/1751143718764529","article-title":"Eye care in the intensive care unit","volume":"19","author":"Hearne","year":"2018","journal-title":"J Intensive Care Soc"},{"key":"R9-20260626","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.jcrc.2012.02.005","article-title":"Exposure keratopathy in sedated and ventilated patients","volume":"27","author":"Jammal","year":"2012","journal-title":"J Crit Care"},{"key":"R10-20260626","doi-asserted-by":"crossref","first-page":"426","DOI":"10.5005\/jp-journals-10071-24470","article-title":"Effect of implementation of an eyecare bundle on incidence of exposure keratopathy in intensive care unit of tertiary care center in north India","volume":"27","author":"Sama","year":"2023","journal-title":"Indian J Crit Care Med"},{"key":"R11-20260626","doi-asserted-by":"crossref","first-page":"318","DOI":"10.3341\/kjo.2020.1112","article-title":"Study of conjunctival microbial flora in patients of intensive care unit","volume":"35","author":"Ramani","year":"2021","journal-title":"Korean J Ophthalmol"},{"key":"R12-20260626","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1016\/S0140-6736(83)92425-X","article-title":"Nosocomial bacterial eye infections in intensive-care units","volume":"321","author":"Hilton","year":"1983","journal-title":"Lancet"},{"key":"R13-20260626","doi-asserted-by":"crossref","first-page":"891","DOI":"10.20546\/ijcmas.2017.603.104","article-title":"Microbiological profile and antimicrobial sensitivity pattern of endotracheal tube aspirates of patients in ICU of a tertiary care hospital in Bhopal","volume":"6","author":"Chandra","year":"2017","journal-title":"Int J Curr Microbiol App Sci"}],"container-title":["Journal of Anaesthesiology Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_59_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:26:00Z","timestamp":1787747160000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_59_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/joacp.joacp_59_25","relation":{},"ISSN":["0970-9185","2231-2730"],"issn-type":[{"value":"0970-9185","type":"print"},{"value":"2231-2730","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"assertion":[{"value":"2025-02-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}