Date of Award


Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)


Occupational Therapy

First Advisor

Kelly Dornbier


Purpose: The purpose of this project was to create an evidence-based Neonatal Intensive Care Unit (NICU) eye examination guideline and associated resources that supported use of non-pharmacological interventions and emphasized the importance of parent education and involvement from both an interdisciplinary and occupational therapy perspective.

Literature Review: Although medically necessary, researchers and practitioners in the NICU interdisciplinary field have discussed pain and stress associated with preterm infant eye examinations (American Academy of Pediatrics [AAP], 2016; Fierson, 2018; Francis, 2016; Pollaci et al., 2020; Samra & McGrath, 2009). Pain and stress likely impact sensory and overall brain development (AAP, 2016; Brummelte et al., 2012; Jeanson, 2019; Ranger et al., 2013; Vinall & Grunau, 2014), as well as occupational outcomes (Hills, 2019; Jeanson, 2019). Some research has aimed to determine the effectiveness of using non-pharmacological interventions for pain and stress (Disher, Cameron, Mitra, Cathcart, & Campbell-Yeo, 2018; Francis, 2016; Pollaci et al., 2020). Parents providing non-pharmacological support to their infants may promote greater infant emotional recovery (Filippa et al., 2019; Jeanson, 2019).

Methodology: To form the basis of this project, a literature review/needs assessment was completed between May and December of 2021. PubMed, the Advances in Neonatal Care Journal, an OT Practice Magazine, and websites from the American Occupational Therapy Association, AAP, Centers for Disease Control and Prevention, National Eye Institute, and the National Association of Neonatal Therapists, were all searched and used. Sources chosen for this review were published between 2005 and 2021. Due to the nature of research related to this project, 10 out of 26 resources included were published either in or prior to 2017.

Product: An evidence-based interdisciplinary eye examination guideline and associated resources were created for the NICU.

Summary: This project emphasized occupational therapists’ use of non-pharmacological interventions for pain and stress management, occupational therapists’ understanding of visual development and the environment, as well as interdisciplinary and parent collaboration. This project was one of the first, if not the first, to create a NICU eye examination guideline initially inspired by and created within the field of occupational therapy. Future research is imperative to promote product sustainability.