8.
9: Instilling Medication i11to Eyes
PURPOSES
1. To treat infection.
2. To instill medication before examination or surgery of eyes.
3. To lubricate eyes.
4. To stain cornea for identifying abrasions and scars.
ARTICLES
1. Sterile gloves.
2. Sterile canon balls soaked in sterile normal saline.
3. Medication.
4. Dry cotton balls.
5. Dry sterile dressing pad and paper tapes.
6. Kidney tray.
PROCEDURE
Nursing action Rationale
1. Identify patient and assess for: Identifies contraindication for instillation of medication Into
a. Allergy to medication. eyes.
b. Appearance of eye and surrounding structures.
c. Lesions, exudate, erythema or swelling.
d. Location and nature of any discharge.
e. Level of consciousness and willingness to cooperate.
f. Patient's knowledge about medication.
g. Use of contact lens.
2. Check medication order
a. Check physician's order for preparation, strength of Prevents medication error.
medication, number of drops, frequency of instillation of
medication and eye to be treated.
OD-;--Oculus Dexter (right eye).
OS-Oculus Sinister (left eye).
OU-Oculus Uterque (both eyes).
b. Check expiry date and medication label.
3. Prepare patient for treatment Reduces anxiety and ensures cooperation
a. Check patient's identification and name. Reduces errors.
b. Explain procedure.
c. Assist the patient to a comfortable position-sitting or
lying with head slightly hyperextended.
d. Obtain assistance for immobilizing in case of young Prevents accid t • . · n
en a1 lnJury during medication adminlstratio ·
children.
e. Remove contact lenses, if pr
4. Wash hands
5. Clean eyelid and eyelashes
a. Don sterile gloves
b. Use sterile cotton swab im cretlons on eyelid and
and wipe from Inner cant e eye. Cleaning toward
minants entering into
Uct.
Chapter 8 Medication Administration W1if ■
Rationale
preparation fo, na
of dr I me, c;tre"glh, cxph y Checkiny nwcl1c:atlon prevents medication error.
ops n Ct!Sl' of liquids
I ,c
patient to look up lo the ( L'llh'CJ. G'IVC l I PL~r~on I<, not likely t o blink if looking up and in this position
sterIIeab so, lH•n1couon b,,11 tlw cnr rw.i is prott•ctecl hy upper lid, A cotton ball can be
u:,ccl to wlpr~ off excess olntmr>nt/ drug from eyelashes after
lnstill.i11on.
tower conjunt tivJI s.ic by pl.lciny thumb 0 1 Placmn l111qe1 on th1: bony prominence avoids pressure to the
non dominant h,rnd just below th e eyl~ on th e eyt>billl ,ind prevents person from blinking or squinting.
k arch u1d gently d1 nw down the skin on the
If th t sc.ues ire edemntou!. ' har)cJle
' ·' ti'~
,c 1.issues
refull~ t-> tW01d ddm.iging them {F,gu,e 8 _9(n)].
r- ,, I
Figure 8.9(a): Exposing lower conjunctiva! sac
Liquid medication: The first drop is considered to be contaminated.
a. Discard the first drop of medication. Patient is less likely to blink if a side approach is used. If droos
b. Approach the eye from the side and instill the correct
fall directly on the cornea, it may cause injury.
number of drops onto the outer third of lower conjunctiva,
holding the dropper 1-2 cm above the eye.
Eye ointment
a. Discard the first bead of ointment.
b. Hold the tube above conjunctiva! sac, squeeze 2 cm of
ointment from tube into lower conjunctiva! sac from inner
canthus outward. Squeezing can injure eye and push out medication.
7- Instruct patient to close eyelid and not to sqeeze them shut. Pressure prevents medication running down the duct.
t 30
8- Instruct patient to press on nasolacrrmal duct for at leaS
.seconds after instilling liquid medication. Prevents spread of 01g3ni~nb Into lacrimnl duct.
9. Clean the eyelid as needed by wiping from inner canthus to
outer canthus. Reduces, bk of inJtll y.
nd
l0. Apply an eye pad if required and secure it with rnpe "
instruct patient not to rub the eye.
11 · Assess patient response.
12. Replace medication.
13
· Wash hands.
14' Document administration: Medication adminlS t ered, number
of drops, and patient's response, etc.
~ P c... ~ es· Tt,e Art of Nurs ng Practice
SPECIAL CONSIDERATIONS
1
If more than one~ edrop (medication) is ordered, wait 5 minutes between each medication.
2.. lnstrut.1. patient, on safety precautions if drops are meant for dilation of pupils.
3. lf medication needs to be instilled into both eyes. Place in the unaffected eye first.
PEDIATRIC VARIATIONS
Infants often clench the lids tightly closed so, place the drops in the nasal corn er, where the lids meet. The medicaaon
pools in this area and when the child opens the lids, the medication flows onto the conjunctiva.
