The patient should be placed in a supine or sitting position with the neck slightly hyperextended. However, never hyperextend the neck of a patient with a cervical spine injury.
If crusts or drainage are present along the eyelid or inner canthus, gently wash. Any dried or difficult to remove crusts should be soaked by applying a damp washcloth or cotton ball over the eye for a few minutes. Always wipe clean from inner to outer canthus.
Hold a cotton ball or clean tissue in non-dominant hand on the patient's cheekbone just below lower eyelid and gently press downward with thumb or forefinger against the bony orbit. Ask the patient to look up at the ceiling.
Drops should be administered above the conjunctival sac. Avoid instilling directly onto the cornea as this area is very sensitive to pain. After the medication has been instilled, ask the patient to close their eyes. With medications that cause systemic effects, gently apply pressure for 30-60 seconds on the patient's nasolacrimal duct.
If the patient blinks or closes their eye and the drop is missed, repeat instillation to ensure administration of medication.
If the patient is to receive more than one eye medication in the same eye, wait at least 5 minutes before instilling the next drop in order to avoid interaction between medications.
Apply a thin stream of ointment into the lower conjunctival fornix, from inner canthus to outer canthus. Then ask the patient to close the eye.
Always clean the area or apply medication from the inner canthus to the outer canthus. This process aids to avoid entrance of microorganisms into the lacrimal duct. Additionally, avoid touching eyelids with anything to prevent infection and never allow another patient to use someone else's medication.
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