Through Different Eyes Sedation and Delirium Management in Intensive Care Unit Patients with Preexisting Visual Impairment

Shibu Sasidharan.1 Shiji Gangadharan.2 Vipin Rana.3 Harpreet Singh Dhillon.4 Kiran Parate.5 Vignesh Jayaprakash.6

.1Level III UN Hospital, Goma, DR Congo, Department of Ophthalmology 

.2King Abdullah Medical City, National Guard Hospital 

.3Riyadh, SAU, Department of Ophthalmology, Command Hospital 

.4Kolkata, West Bengal, India Fairview General Hospital Internal Medicine 

.5Research & Development Scientist, Nakodas Group, Bagadganj, Maharashtra 

.6Symbiosis International University

Correspondence: Shibu Sasidharan, Team Leader, Dept of Anaesthesia and Critical care, Level III UN Hospital, Goma, DR Congo.

Received: December 23, 2025                                                         Published: March 20,2026

Citation: Shibu Sasidharan, Cardiovascular Disease Events in Hemotoxic Snakebite Envenoming: A Prospective Observational Study from Himachal Pradesh, India. AOJ Emerg and Int Med. 2026;1(3):79–84.

Copyright: ©2026 Shibu Sasidharan. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially.

Abstract 

Preexisting visual impairment affects approximately 2.2 billion people globally and represents a significant but often overlooked consideration in the development of delirium in intensive care unit (ICU) settings. This commentary examines the current understanding of how visual impairment influences sedation requirements and delirium incidence in critically ill patients. Evidence from systematic reviews and observational studies suggests that sensory impairments—particularly when visual and hearing deficits co-occur—are associated with increased vulnerability to ICU delirium. Current evidence indicates that multicomponent, nonpharmacological interventions tailored specifically for visually impaired patients may reduce delirium incidence and duration, though direct evidence in this specific population remains limited. This review synthesizes available clinical findings, proposes recommendations for optimizing sedation protocols and delirium prevention strategies for this vulnerable population, and identifies critical gaps in current research that require further investigation. 

Keywords: Critical care, delirium prevention, intensive care unit delirium, multicomponent intervention, nonpharmacological intervention, sedation management, sensory deprivation, visual impairment

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