Ocular Complications in the Prone Position in the Critical Care Setting: The COVID-19 Pandemic

<jats:sec><jats:title>Purpose:</jats:title><jats:p> Ocular complications are common in the critical care setting but are frequently missed due to the focus on life-saving organ support. The SARS-CoV-2 (COVID-19) pandemic has led to a surge in critical care capacity and prone positioning practices which may increase the risk of ocular complications. This article aims to review all ocular complications associated with prone positioning, with a focus on challenges posed by COVID-19. </jats:p></jats:sec><jats:sec><jats:title>Materials and Methods:</jats:title><jats:p> A literature review using keywords of “intensive care”, “critical care”, “eye care”, “ocular disorders”, “ophthalmic complications,” “coronavirus”, “COVID-19,” “prone” and “proning” was performed using the electronic databases of PUBMED, EMBASE and CINAHL. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The effects of prone positioning on improving respiratory outcomes in critically unwell patients are well established; however, there is a lack of literature regarding the effects of prone positioning on ocular complications in the critical care setting. Sight-threatening ophthalmic disorders potentiated by proning include ocular surface disease, acute angle closure, ischemic optic neuropathy, orbital compartment syndrome and vascular occlusions. </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> COVID-19 patients may be more susceptible to ocular complications with increased proning practices and increasing demand on critical care staff. This review outlines these ocular complications with a focus on preventative and treatment measures to avoid devastating visual outcomes for the patient. </jats:p></jats:sec>