Abstract
PURPOSE: This review evaluates the epidemiology, risk factors, and effectiveness of nursing interventions for preventing ocular surface disorders in intensive care unit (ICU) patients from 2020 to 2025. METHODS: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with study quality and bias assessed using standardized tools. Comprehensive searches of 6 databases from January 2020 to May 2025 identified 40 eligible studies on ocular surface disorders in ICU patients, including randomized trials, cohort studies, and meta-analyses. Due to heterogeneity, a narrative synthesis was used. Risk of bias was assessed with ROBINS-I and Cochrane tools, with subgroup analyses based on ventilation status and ICU type. RESULTS: The incidence of ocular surface disorders in intensive care unit patients ranged from 20% to 60%, with dry eye disease (DED) occurring in 40%, exposure keratopathy in 23%, and conjunctivitis in 25% of cases. Major risk factors included mechanical ventilation, incomplete eyelid closure, prolonged sedation, and low environmental humidity. Multimodal nursing interventions that combined eyelid closure, ocular lubrication, moisture chamber application, and staff education effectively reduced the incidence of corneal injury from 69.7% to 13.8% in high-risk patients. Passive blinking exercises demonstrated significant effectiveness and feasibility in low-resource settings. CONCLUSIONS: Ocular surface disorders are common in ICU patients but can be effectively prevented through standardized care, eye protection, lubrication, and staff training. Incorporating eye care into daily routines improves safety and visual outcomes, whereas simple measures like passive blinking remain practical and valuable.