ADMINISTERING EYE INSTILLATION

A. Definition

Ophthalmic instillation – the insertion of medication in the form of liquids or ointments

into the eyes.

B. Purposes

1. To lubricate the eye or socket of a prosthetic eye.

2. To anesthetize the eye, dilate the pupil and stain the cornea.
3. To decrease intraocular pressure
4. To provide direct route for local effect
5. To obtain desired therapeutic effect

C. Equipment

Clean gloves
Sterile, absorbent sponges soaked in sterile normal saline
Medication
Medication ticket
Paper towel
Sterile eye dressing (pad), as needed, and paper eye tape to secure it.

D. Planning and Implementation

ACTION RATIONALE
1. Verify the medication order. To ensure accuracy in drug administration.

a. Check the physician’s order for the

preparation, strength and number of drops.

b. Also confirm the prescribed frequency of

the instillation and which eye to be treated.

c. Abbreviation are frequently used to identify

the eye: OD (right eye), OS (left eye), OU (both
eyes).
2. Compare the label on the medication tube To ensure accuracy.
or bottle with the medication record, and
check the expiration date.
3. If necessary, calculate the medication
dosage.
4. Perform hand hygiene, and observe other To prevent contamination.
appropriate infection control procedures.
5. Introduce yourself, and verify the client’s To reduce client’s anxiety.
identity. Explain to the client what you are

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going to do, why it is necessary, and how the
client can cooperate.
6. Provide for client privacy.
7. Prepare the client.

a. Assist the client to a comfortable position, To promote comfort.

either sitting or lying.

b. Tilt the client’s head toward the affected So that the solution will run from the eye
eye. to the basin and not to the other eye.

c. Ensure that the light source does not shine To protect the eye.
into the client’s eyes.

d. Place a drape and position the basin against To protect the client and the bedclothes.
the cheek below the eye on the affected side.
8. Assess the eye. This serves as a basis for future
assessment and evaluation.
a. Assess the eye for redness, the location and
nature of any discharge, lacrimation and
swelling of the eyelids or of the lacrimal gland.

b. Note any complaints like itching, burning,

pain, blurring of vision, etc.

c. Observe the client’s behavior like squinting,

blinking excessively, frowning, or rubbing the
eyes.
9. Clean the eyelid and the eyelashes. Material on the eyelid and lashes, if not
removed, can be washed into the eye.
a. Put on clean gloves.

b. Use sterile cotton balls moistened with To prevent contamination of the outer eye
sterile irrigating solution or sterile normal and the lacrimal duct.
saline, and wipe from the inner canthus to the
outer canthus.
10. Administer the eye medication.

a. Check the ophthalmic preparation for the To prevent a medication error.

name, strength, and number of drops, if a
liquid is used. Draw the correct number of
drops into the shaft of the dropper, if a
dropper is used. If ointment is used, discard
the first bead.
b. Instruct the client to look up to the ceiling.
Give the client a dry, sterile, absorbent
sponge.
The first bead of ointment from a tube is
considered contaminated.
To prevent the client from blinking while
the top eyelid partially protects the
cornea.

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c. Expose the lower conjunctival sac by placing To minimize the possibility of touching the
the thumb or fingers of your nondominant cornea, to avoid putting pressure on the
hand on the client’s cheekbone, just below the eyeball, and to prevent the person from
eye, and gently drawing down the skin on the blinking or squinting.
cheek. If the tissues are edematous, handle
the tissues carefully to avoid damaging them.
d. Holding the medication in the dominant To prevent the client from blinking.
hand, place your hand on client’s forehead to To prevent harm on the cornea.
stabilize your hand. Instill the correct number
of drops onto the outer third of the lower
conjunctival sac. Hold the dropper 1-2 cm (0.4-
0.8 inches) above the sac; or
e. Holding the tube above the lower
conjunctival sac, squeeze 2cm (0.8 inches) of
ointment from the tube into the lower
conjunctival sac from the inner canthus
outward.
f. Instruct the client to close eyelids but not to To spread the medication over the eyeball.
squeeze them shut. Squeezing can injure the eye and push the
medication out.
g. For liquid medications, press firmly or have To prevent the medication from running
the client press firmly on the nasolacrimal duct out of the eye and down the duct.
for at least 30 seconds.
11. Wipe the eyelids gently from the inner to To prevent contamination while collecting
the outer canthus. excess medication.
12. Apply an eyepad if needed, and secure it To protect the eye, as needed.
with paper eye tape.
13. Assess the client’s response. To assess the client’s reaction
14. Do after-care of supplies and equipments To prevent the spread of microorganism.
and wash hands.
15. Document. Chart the administration of
medication on the medication sheet after the
drug has been administered.

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