Q: Patient has been made "comfort care" due to terminal illness and neurologic coma . Family is very distressed due to persistently open eyes. How you can help patient and family?
Answer: Malnutrition leads to loss of the retro-orbital fat pad and orbit fall back posteriorly within its socket. Patient may not be able to close eyelids properly and persistently open exposure may cause conjunctival ulceration. Use of lubricants and artificial tears may prevent pain from ulceration. Simultaneously, it is important to explain the process to family and provide emotional support.