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Eyedrop instillation is the dispensation of a sterile ophthalmic medication into a patient's eye.
Eyedrops may be instilled to treat a number of eye disorders or to anesthetize an eye before treatment. An ophthalmic assistant, technician, nurse or physician instills eyedrops during a routine eye examination or during treatment for ocular disease. Anesthetic eyedrops are instilled before surgery on the eye. Sometimes ophthalmic professionals instill dyes to help diagnose ocular disease, either by traditional methods, or by intravenous administration, or by the use of strips.
Eyedrops or ophthalmic solutions are used to treat glaucoma, uveitis, allergic reactions and infections. Dilatory eyedrops may be instilled during an examination to achieve a better view of the retina.
Health care professionals need to ensure that the proper drug is being instilled and that it has not passed its expiration date. Some ophthalmic solutions may be contraindicated or can cause allergic reactions. Eyedrop containers should be clearly labeled and checked before instillation.
The eyedrops should also be monitored for discoloration or sedimentation, which indicate that the ophthalmic solution is decomposing. In that case, a new dose of medicine should be obtained and the affected bottle discarded.
Moreover, the ophthalmic staff member dispensing the drops should double-check the patient's identification and chart to ensure the correct dose is being instilled into the correct eye. The dispensing ophthalmic professional should never touch the tip of the eyedropper to the patient's eye. Touching will contaminate the remaining medication. In case of direct eye contact, the medication should be thrown away.
Sterilization is an important part of eyedrop instillation. Before eyedrops are instilled, the ophthalmic assistant, technician, nurse, optometrist, or ophthalmologist should wash his or her hands thoroughly. The ophthalmic staff member then should gather all necessary supplies. For some eyedrops, the dispenser may want to warm the drops to body temperature by holding the bottle in his or her hand for about two minutes.
Next, the dispenser should position the patient correctly. The patient should sit back in the examination chair with their head slightly hyperextended. Once the patient is correctly positioned, the dispenser should clean the eyelids from the inner canthus outward with a sterile saline solution to remove any eye secretions or previously instilled medications. The dispenser should wash their hands after these preparations are completed.
Immediately before instillation, the dispenser should depress the patient's lower lid with the finger of one hand and lightly pinch the patient's lower lid to make a pouch for the medication. The upper lid should also be held open to prevent blinking during instillation. The dispenser should tell the patient to look up. Using the other hand, the dispenser should instill the drop into the everted lower lid. The drops should not be instilled on the cornea. This precaution is necessary to avoid startling the patient, or causing unnecessary pain.
After the appropriate amount of medication is instilled, the ophthalmic professional should release the lid and remove any excess fluid. The patient should be told to gently close their eyes so as to not release any medication. If another medication is to be instilled, a delay of at least 30 seconds is required between instillations.
Author Info: Mary Bekker, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002
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