This study was designed as a prospective, randomized controlled experimental study aiming to compare different approaches to eye care in intensive care patients receiving mechanical ventilation. In this study, patients receiving mechanical ventilation in the intensive care unit will be randomly assigned to four groups using a simple randomization method:
1. Control Group: Standard Eye Care 2. Intervention Group 1: Eye Care with Eye Care Kit 3. Intervention Group 2: Eye Care According to Eye Care Protocol 4. Intervention Group 3: Eye Care with Both Protocol and Eye Care Kit Research Hypotheses H1: Eye care provided using a care protocol is more effective in preventing the development of complications compared to standard eye care.
H2: Eye care provided using an eye care kit is more effective in preventing the development of ocular complications compared to standard eye care.
H3: The combined use of an eye care kit and a care protocol is more effective in preventing the development of ocular complications compared to using the care protocol alone.
H4: The use of an eye care kit is more effective in preventing the development of ocular complications compared to the use of a care protocol.
Age 18 years or older
Receiving mechanical ventilation
Glasgow Coma Scale (GCS) score < 12
At least 24 hours have passed since ICU admission
Diagnosed with brain death
Presence of facial or ocular trauma
Patients with head trauma
Patients who have undergone brain surgery
Parallel
Control Group: Standard Eye Care Group
Other interventionThere is no established protocol or guideline for eye care in the intensive care unit where the study will be conducted. Routine eye care involves the use of sterile gauze and sterile saline. During routine suctioning procedures, patients' eyes are not closed. If a patient is unable to achieve full eyelid closure, their eyes are covered with an eye patch or sterile gauze. The Schirmer test will be administered to both eyes on the first day (prior to the first eye care intervention), as well as on the fifth, seventh, and tenth days after eye care is performed. Signs and symptoms of eye infection and chemosis will be evaluated daily after the second eye care procedure. Data for this group will be collected, and the administration and documentation of eye care will be monitored.
Intervention Group 1: Eye Care Using an Eye Care Kit
Other interventionEye care will be performed using an eye care kit. All nursing staff in the intensive care unit will receive training regarding the contents and usage of the kit. Patients in this group will receive eye care solely using the kit, following a 4-times-daily care protocol. For patients with lagophthalmos, eyes will be covered using the eye closure pad provided in the kit. The Schirmer test will be performed on both eyes on the first day prior to the initial eye care intervention, and on the fifth, seventh, and tenth days following eye care, with results recorded. Signs of infection and chemosis will be assessed daily after the second eye care session. Data collection will be done using , and eye care administration will be tracked.
Intervention Group 2: Eye Care According to an Eye Care Protocol
Other intervention* All ICU nursing staff will be educated on the eye care protocol. A copy of the protocol will be posted on the doors of the rooms of patients receiving care under the protocol. * Patients' ocular risk factors will be assessed daily, followed by eye care based on the protocol. * Changes in ocular condition will be assessed and documented, and ICU physicians will be informed as necessary. * In cases of incomplete eyelid closure, eyes will be covered upon physician notification. * Patients will be assessed daily for signs of eye infection and conjunctival edema in accordance with the protocol. If signs of infection or complications occur during the day, they will be marked with a (+) symbol on the form. * The Schirmer test will be applied on the first day (prior to the initial eye care session) and after eye care on days 5, 7, and 10, with results documented.
Intervention Group 3: Eye Care Using Both the Eye Care Protocol and the Eye Care Kit
Other intervention* ICU nursing staff will be educated on the eye care protocol. A copy of the protocol will be posted on the doors of the rooms of patients receiving this combined care. * Eye care will be performed using the Eye Care Kit developed by the researchers in accordance with the protocol. * Patients will be assessed for ocular risk factors daily, and eye care will be provided according to the management guidelines of the protocol. * In cases of incomplete eyelid closure, the eyes will be covered with physician knowledge. * Patients will be assessed daily for signs of infection and conjunctival edema as per the protocol. Any signs of infection or complications will be marked with a (+) on the form. * The Schirmer test will be performed on both eyes before the first eye care session on day 1, and following eye care on days 5, 7, and 10, with results recorded.
Conjunctival Edema in Critically Ill Patients
Conjunctival Edema (Chemosis): Chemosis is the edema of the conjunctiva, which is a thin, transparent membrane covering the inner surface of the eyelids and the white part of the eyes (sclera). It refers to the swelling of this membrane that lines the ocular surface.
Ocular Infections in Critically Ill Patients
Signs and Symptoms of Ocular Infection: Redness, ocular discharge, crusting along the eyelid margins, adhesion of eyelashes (eyelashes sticking together), corneal discoloration (loss of corneal transparency), periorbital edema.
Dry Eye in Critically Ill Patients
Dry Eye: Dry eye is a multifactorial disease of the ocular surface, defined by tear film instability and associated with symptoms including ocular discomfort, burning sensation, irritation, dryness, visual blurring, and foreign body sensation."
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