I LOVE this study.

It’s not that gel versus drops is a novel notion or even necessarily the best way to prevent dry eye in critical care. But the study highlights a very important and terribly overlooked issue and looks at simple steps that could make it better.

Reading this reminded me of a conversation I had once with an intensive care doctor who was looking for something that would help protect the corneas of a critically ill patient whose lids would not close - but the limiting factor was, they needed to be able to check the pupillary response regularly, so they were looking at bubble eye bandages, for example, with slight vents so that they would provide some protection while also not completely fogging up.

Effectiveness of Nursing Interventions to Prevent Dry Eye in Critically Ill Patients. de Araujo et al, Am J Crit Care. 2019 Jul;28(4):299-306.

BACKGROUND:
Critically ill patients are susceptible to the development of dry eye. Few studies have been conducted on how to best prevent and treat this condition.
OBJECTIVE:
To compare the effectiveness of 2 nursing interventions in preventing dry eye in adult intensive care unit patients: liquid artificial tears (Lacribell; Latinofarma) and artificial tears gel (Vidisic Gel; Bausch and Lomb).
METHODS:
In this randomized controlled trial, 140 participants were randomly assigned to 1 of 2 treatment groups: a liquid artificial tears group (n = 70) and an artificial tears gel group (n = 70). The study inclusion criteria were as follows: admission to the intensive care unit, age of 18 years or older, no diagnosis of dry eye at admission, receipt of mechanical ventilation, blink rate of less than 5 times per minute, and a score of 7 or less on the Glasgow Coma Scale. On 5 consecutive days, a single researcher who was unaware of the treatment assignment assessed the participants' eyes using the fluorescein eye stain test and the Schirmer test for dry eye.
RESULTS:
Dry eye developed in 21% of participants who received liquid artificial tears versus 9% of participants who received artificial tears gel (P = .04).
CONCLUSIONS:
In this study, artificial tears gel was superior to liquid artificial tears in preventing the development of dry eye. These results may help nurses deliver evidence-based eye care aimed at reducing the risk of dry eye in critically ill patients.