Objective To develop a risk assessment scale for exposure keratopathy in ICU patients, and to test its reliability and validity. Methods An initial item pool was formed after systematic literature review, which was improved through a 2-round Delphi consultation to develop a Risk Assessment Scale for Exposure Keratopathy in ICU Patients. A total of 298 ICU patients were selected by convenience sampling method, then they were investigated by utilizing the scale to testits reliability and validity, and its optimal critical value was determined by drawing the operating characteristic curve. Results The Risk Assessment Scale for Exposure Keratopathy in ICU Patients included 3 dimensions and 12 risk factors. In the two rounds consultation, the positive coefficients were 100% and 80.95%，and the authority coefficients were 0.892 and 0.888, and Kendall harmony coefficients were 0.364 and 0.492. The overall Cronbach′s α coefficient of the scale was 0.834, its half-fold reliability, inter-rater reliability and content validity index were 0.795, 0.841 and 0.917 respectively. The optimal critical value was 8.5 points and the area under the operating characteristic curve was 0.925. Conclusion The Risk Assessment Scale for Exposure Keratopathy in ICU Patients has good reliability and validity, and it can be used to assess the risk of exposure keratopathy for ICU patients.