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Year : 2022  |  Volume : 4  |  Issue : 1  |  Page : 28

Corneal perforation in a patient with COVID-19 pneumonia under helmet continuous positive airway pressure ventilation treatment

Department of Ophtalmology, Centro Hospitalar De Entre O Douro E Vouga, Santa Maria Da Feira, Portugal

Correspondence Address:
Maria Joao Matias
Department of Ophtalmology, Centro Hospitalar De Entre O Douro E Vouga, Rua Cândido Pinho, Santa Maria Da Feira
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/pajo.pajo_1_22

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Ocular surface complications secondary to continuous positive airway pressure (CPAP) machines have been previously reported such as ocular irritation, dry eye disease, lid laxity, and floppy eyelid syndrome. No severe ocular complications have been specified in the literature. We report a serious ocular complication in a patient under helmet CPAP (hCPAP). A 68-year-old male with COVID-19 pneumonia required ventilatory support with hCPAP. Following 5 days, the patient started complaining of ocular discomfort, purulent discharge in his left eye, and ocular dryness upon awakening. Ophthalmological examination showed no light perception in the left eye and slit-lamp biomicroscopy revealed atalamia, loss of corneal transparency with superior infiltrates, and a total epithelial defect with iris herniation and a central perforation. Considering the patient's progressive worsening clinical condition, with a painful blind eye, left evisceration was performed. It is important to be aware of possible ophthalmological complications related to ventilation since prompt diagnosis and treatment can avoid poor visual outcomes. In this clinical case, we faced a serious ocular complication following hCPAP ventilation.

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