Knock Knock Eye: What Happens When Your Eyelids Won’t Close?

This week, I’m answering your YouTube questions, including why my histology shirt is back, and then diving into a mystery case straight from the ICU. A sedated teenager with a swollen face, red eyes, and a whole lot of chemosis needs help, and I show up with… my ophthalmologist luggage.

What I found is something every ICU clinician has seen but doesn’t always recognize: exposure keratopathy, the completely preventable eye emergency that happens when the lids won’t close, the tears disappear, and the cornea gets sacrificed to hospital airflow.

Takeaways:

• How facial edema and chemosis in the ICU create the perfect setup for exposure keratopathy and why it often goes unnoticed.

• Why artificial tears twice a day are nowhere near enough for a sedated patient who can’t blink.

• The simple bedside tools ophthalmologists bring to evaluate non-responsive patients (including the portable slit lamp).

• Why corneal abrasions in hospitalized patients can become dangerous fast and how to stop them before they start.

• The easiest ICU intervention ever: ointment, moisture chambers, and remembering that eyelids exist for a reason.

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A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information. 

Today’s episode is brought to you by Microsoft Dragon Copilot. Dragon Copilot is an AI clinical assistant that streamlines documentation, surfaces critical information, and automates routine tasks — empowering healthcare teams to focus more on patients and less on administrative work. Learn more at ⁠⁠https://glau.cc/Dragon⁠⁠

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