Name: ___Julianne B. dela Cruz ______________________________________________ Date: _Jan.

5, 2021___

Evaluator/Signature: ________________________________________________________ Grade: _____________

ADMINISTERING OPHTHALMIC MEDICATIONS

Definition: Medications administered to the eye using irrigation or instillation

Purpose: An eye irrigation is admitted to wash out the conjunctiva sac

Indication: to provide an eye medication the client requires to treat an infection; to remove secretions or foreign bodies or to remove chemicals that may injure the eye

Contraindication: patients with hypersensitivity to drug

Special considerations:
● INFANTS/CHILDREN:
1. Immobilize the arms and head of the child to prevent accidental injury due to sudden movement during the procedure. Let the parent hold the infant or young child.
2. In infants and children, use a doll to demonstrate the procedure to facilitate cooperation and decrease anxiety.
3. Explain the technique to the parents of an infant or child.
4. An IV bag and tubing may be used to deliver irrigating fluid to the eye.

Equipment needed:
1. Clean gloves
2. Sterile absorbent sponges soaked in sterile normal saline
3. Medication
4. Sterile eye dressing (pad) as necessary and paper eye tape to secure it
5. For irrigation, add:
a. Irrigation solution (e.g. normal saline)
b. Irrigating syringe or tubing
c. Dry sterile absorbent sponges
d. Moisture resistant towel

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 e. Basin (e.g. emesis basin)
PERFORMED
PROCEDURE RATIONALE REMARKS
YES NO
PREPARATION
1. Check the MAR for the drug name, dose, frequency, and which Abbreviations are frequently used to identify the eye OD
particular eye to treat. Be familiar with abbreviations used. (right eye), OS (left eye), CU (both eyes)

2. Compare the MAR w/ the physician’s order. To see if there has been any changes in the physician’s order
that were overlooked

3. Know the reason why the patient is receiving the drug, its To answer questions raised by the patients. To relieve the
classification, contraindication, usual dosage range, side effects patient’s anxiety and correct misconceptions
and nursing considerations for administration of the drug and
evaluation.
PERFORMANCE
1. Check the medication card against the original physician’s order. To avoid administration of wrong drug and to ensure
Match up the label of the medication tube/bottle with the optimum benefit from the drug is achieved
medication card and check the expiration date.

2. Identify the client by letting the conscious client say his full To avoid administering the wrong drug or to wrong patients
name and verify by looking at the client’s wristband, which has
his name and hospital ID number written on it.

3. Bring the medication to the client’s bedside. Provide privacy. To ease patient’s apprehensions and ease or ensure
Explain the procedure to the patient. compliance to therapy

4. Wash hands. Observing appropriate infection control measure avoids

cross contamination

5. Assist client to a comfortable position, either sitting or lying To facilitate cooperation

down.

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

6. Don gloves then cleanse the eyelids and eyelashes of any If dirt is removed, it could be washed into the eye. Cleaning
drainage with a washcloth moistened with normal saline solution toward the outer cantus prevents contamination of the other
from the inner to the outer canthus. Use each area of the eye and the lacrimal duct
washcloth only once.

PROCEDURE PERFORMED
RATIONALE REMARKS
YES NO
7. Give the client a dry sterile absorbent sponge. To prevent patient from getting wet, maintain patient
comfort

8. Tilt the client’s head back slightly. The head may be turned to To keep the rest of the medication sterile. The first bead/
the affected side. Remove the cap from the medication bottle, drop of medication is considered contaminated
being careful to no touch the inner side of the cap. Discard the
first bead/drop of medication.
9. Invert the monodrip plastic container that is commonly used to The client is likely to blink if looking up. The first bead/
instill eyedrops. Instruct the client to look up while focusing on drop is considered contaminated
something on the ceiling.

10. Place the thumb or two fingers near the margin of the lower The lower conjunctiva sac is exposed as the lower lid is
eyelid immediately below the eyelashes and exert pressure pulled down
downward over the bony prominence of the cheek.

11. EYEDROPS: Hold the dropper close to the eye approaching from
the side, but avoid touching the eyelids or lashes. Squeeze the
container and allow the prescribed number of drops to fall on the
outer third of the lower conjunctival sac. Hold the dropper 1 to 2
cm above the sac.

EYE OINTMENT: Hold the tube above the lower conjunctival Using the cleanest – dirtiest method
sac, squeeze 2 cm of ointment from the tube into the lower
conjunctival sac from the inner canthus outward.

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

  Release the lower lid after the eyedrops/ointment are Closing the eye spreads the medication over the eyeballs.
instilled. Ask the patient to close the eyes gently. Squeezing can injure the eye and pushes the medication

 Apply gentle pressure over the tear duct for at least 30 Prevents the eye drop from flowing into the tear duct
seconds.

PROCEDURE PERFORMED
RATIONALE REMARKS
YES NO
IRRIGATION VARIATION:
 Place absorbent pads under the head, neck, and shoulders.
Position the curved basin at the cheek on the side of the To catch drainage
affected eye. If the client is sitting up, ask him to hold the
basin.

 Expose the lower conjunctival sac. Or to irrigate in stages, To expose the lower conjunctival sac and easy
first hold the lower lid down, then hold the upper lid up. administration of medication
Exert pressure on the bony prominences of the cheekbone
and beneath the eyebrows when holding the eyelids.
 Fill and hold the eye irrigator about 1 inch from the eye. At this height, the pressure of the solution will not damage
the eye tissue, and the irrigator will not touch the eye

 Irrigate the eye, directing the solution onto the lower

conjunctival sac and from the inner to outer canthus.
 Irrigate until the solution leaving the eye is clear (no
discharge present) or until all the solution has been used.
Instruct the client to close and move the eye periodically.
Prevents possible injury to the connect and prevents fluid
and contaminants from flowing down the nasolacrimal duct
Eye closure + movement moves secretions from the upper to
lower conjunctival sac

12. Clean and dry the eyelids as needed. Wipe the eyelids gently
from the inner to outer canthus. To collect excess medication

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

 13. Apply an eye pad if needed, and secure it with paper eye tape.
Instruct client not to rub the affected eye. To protect the eye and to prevent irritation

14. Remove gloves and perform hand hygiene.

To prevent cross contamination

PROCEDURE PERFORMED
RATIONALE REMARKS
YES NO
15. Dispose all supplies appropriately. Replenish stocks for next
dose. To avoid contamination of unused drugs

16. Assess the client’s response right after the instillation or

irrigation. Return to the client within the appropriate time frame To evaluate patient’s response to medication
and report significant deviations from normal to the physician.

17. Chart the medication administered. To provide data on patient’s compliance to therapy

Learner’s Reflection: (What did you learn most of the activity? What is its impact to Instructor’s Comments:
you?)

I have learned about the proper way of administering ophthalmic medication and the
important things to put in mind while administering them.

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41