Eye Instillation


a.To combat infection
b.To relieve pain and discomfort
c.To dilate or constrict the pupil

Indications: Eye examination treatment of disease.
Contraindications: Allergies to the medications.
Nursing Alert: Solutions and ointments introduced into the eye should be sterile and careful measures of medical asepsis should be followed.
a.Record time on which the medication was instilled.
b.Type, strength and amount (dosage) of the medication
c.The eye onto which the medication was instilled.
Equipment: Sterile solution of medication, small gauze squares or cotton balls
1.Check the patient’s name
Rationale: For proper patient identification.
2.Check physician’s directives.
Rationale: To avoid medication error.
3.Wash hands prior to instilling medication.
Rationale: To prevent transfer of microorganisms to the patient.
4.Cleanse the eyelids and lashes with cotton balls or gauze pledgets moistened with normal saline.
Rationale: Prevent debris to be carried into the eye when the conjunctival sac is exposed.
5.Use each cotton ball or pledget for only one stroke, moving from the inner to the outer canthus of the eye.
Rationale: Prevents carrying of debris to the lacrimal duct.
6.Tilt the patient’s head back slightly if he is sitting or place the head over a pillow if he is lying down.
Rationale: To prevent solution or tear from flowing towards the other eye.
7.Fill eye dropper with medication but prevent from flowing back into the bulb end.
Rationale: Loose particles of rubber from bulb end may slip into medication.
8.Using forefinger, pull lower lid down gently.
Rationale: To expose inner surface of lid and cul-de-sac
9.Instruct patient to look upward.
Rationale: Prevent medication from sensitive cornea.
10.Hold the dropper close to the eye but avoid touching the eyelids.
Rationale: Touching the eyelids may startle the patient and cause him to blink.
11.Avoid touching the eyeball with the dropper.
Rationale: Touching the eyeball with the dropper would injure the eye.
12.Allow the prescribed number of drops to fall in the lower conjunctival sac but do not allow to fall onto the cornea.
Rationale: It cases unpleasant sensation to the patient or may injure the cornea.
13. Release the lower lid after the drops are instilled. Instruct the patient to close eyes slowly, move the eye and not to squeeze or rub.
Rationale: Squeezing or rubbing may irritate the eye tissue or would express the medication from the eye. Closing and moving the eye allow medicines to be distributed over the eye.
14.Wipe off excess solution with gauze or cotton balls.
Rationale: Prevents possible skin irritation.
15.Wash hands after instilling the medication.
Rationale: Prevents transfer of microorganisms to self or to other patients.


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