In what situations do we have to put drops in our eyes? There are many examples. With the help of drops you can anesthetize the eyeball in case of injury, stop the infectious process in case of viral, bacterial or fungal conjunctivitis, improve circulation intraocular fluid, reduce intraocular pressure in glaucoma and even slow down the progression of cataracts. Additionally, many people use eye drops How symptomatic remedy To quickly relieve redness and irritation (including allergic) from the eyes, some people instill eye drops with solutions of vitamins and nutrients in order to improve tissue trophism. Whatever you use eye drops for, it is important to know how to properly instill eye drops, because the effectiveness of the entire treatment often depends on the instillation technique.
How to apply eye drops correctly: a simple algorithm.
Instillation eye drops– this is the scientific name for eye drops. This manipulation is often used in ophthalmology in the treatment of eye diseases. The procedure is carried out by trained nurses. However, after reading the information below, you can easily apply eye drops correctly at home yourself:
1. Wash your hands with soap. There is no need to use antiseptic solutions. Thorough hand washing with soap and running water is sufficient, because during the manipulation there is no direct contact of the conjunctiva with the skin of the hands.
2. If the bottle has a built-in dropper, then simply remove the cap. If a dropper is not provided, you will have to use a pipette (pipettes with a narrow spout are best). Pipette a small amount of medication using a large and index finger working hand.
3. To properly apply eye drops, a person must sit or lie down. When sitting, your head should be tilted back. During instillation of drops, the patient's gaze should be directed upward.
4. Smoothly pull down the lower eyelid with the index or middle finger of your non-working hand (for right-handers - left, for left-handers - right). For convenience, place a clean and slightly damp cotton or gauze swab under your finger. It will help absorb excess liquid if excess drops leak out of the eye.
5. Hold the pipette or dropper bottle at a distance of 1.5 - 2 cm from the eyeball. During manipulation, do not touch the tip to the eye, conjunctiva or eyelashes. Any contact with a body surface risks infection of the pipette. If this does happen, then the pipette is washed and boiled, and the bottle is replaced with a new one.
6. Click on the pipette (bottle) and inject 1-2 drops of medicine into the conjunctival sac (this is exactly the volume that the human conjunctival cavity can accommodate).
7. It is recommended to keep your eyes open for 30 seconds to active substance better distributed over the entire surface of the conjunctiva. However, the introduction of some drops is accompanied by a burning sensation. It's okay if you immediately close your eyes and gently massage them by placing your finger on your upper eyelid.
8. At the inner corner of the eye there is a lake of tears. From there, the tear (or any liquid that gets into the eye) can freely flow into the nasal cavity through the lacrimal canal. Press on the inner corner for 1-3 minutes closed eye to prevent the medication from leaking into the nasal cavity. If this is not done, the therapeutic effect will be significantly less. In addition, the nasal mucosa is densely supplied with vessels through which the active substance of eye drops can be absorbed and lead to undesirable systemic effects.
9. Done! You have completed the manipulation.
How to put eye drops correctly: a few secrets.
1. All eye drops are produced and packaged under sterile conditions. When opening and using the bottle, we violate sterility. To prevent excessive contamination of the medicine by microorganisms, an opened bottle should not be used for more than 30 days. The medicine should be stored in a dark place at a temperature below 30 degrees. When stored in the refrigerator, the drug is heated to body temperature before use, which reduces discomfort when instilled.
2. If you use contact lenses, then while instilling the drops it would be more correct to refuse to wear them in favor of traditional glasses. If this is not possible, put on lenses no earlier than 30-40 minutes after the procedure.
Location
The concept of “conjunctival sac” hardly means anything to an ordinary person. Someone may remember the disease “conjunctivitis,” but it is unlikely that the first person you meet will tell you where this bag is located and how to find it. Of course, if this first person you meet does not turn out to be an ophthalmologist. In fact, everything is extremely simple: the lower conjunctival sac can be seen by pulling back the lower eyelid of the eye. The space between the lower eyelashes and the eyeball is what you are looking for. This space is inner side century - lined with conjunctiva, tissue rich in blood vessels.
Diseases and inflammationsAccordingly, conjunctivitis is an inflammation of this tissue, accompanied by redness, itching, tearing and sometimes the discharge of pus. There is also an upper conjunctival sac - respectively, under the upper eyelid. Conjunctivitis is often observed in young children, as well as in adults who do not have the habit of washing their hands frequently. Scratching your eye can easily introduce germs and cause inflammation; This is also how allergies can manifest themselves, for example, to new mascara. Neither children nor adults should under any circumstances be treated at home; you should definitely consult a doctor, since it is not always possible to correctly diagnose at home and prescribe correct treatment. In infants, conjunctivitis is often confused with dacryocystitis, an inflammation of the tear duct, which is treated completely differently.
Treatment of diseases and inflammations
The ophthalmologist determines possible reason occurrence of the disease and prescribes appropriate medications. As a rule, these are drops and ointments that need to be instilled and placed in the conjunctival sac of the eye. Without this skill, this can be difficult at first, especially with young children. You may even need help from another person.
How to put drops into eyes?
First you need to wash your hands thoroughly. If you need to instill drops for yourself, the easiest way is to do it in front of a mirror. In one hand you need to take a bottle of drops or a pipette, with the other hand you need to pull down the lower eyelid, opening the conjunctival sac, throw back your head and roll your eyes or look up. Drops should be instilled closer to the outer corner of the eye. It is much easier for a newborn to put them in the eyes than for an older child, because they usually behave quite calmly during the procedure.
After washing your hands, you need to fix the child’s head, and also try to pull both eyelids. This may not work right away, you should try again. Drops must be instilled into the conjunctival sac quickly enough so that the child does not have time to blink and all efforts do not go to waste. At first, it may be much more convenient and easier to instill drops into the child’s eyes in pairs - so that one person holds the child’s head, and the second directly carries out the procedure. Placing ointment in the lower eyelid follows the same principle. So, most likely, most people have an idea of the existence of such a part of the eye as the conjunctival sac, but simply do not know its name. Actually, its name will never be useful to those whose eyes are healthy.
Indications. Treatment, diagnosis, pain relief during various manipulations.
Contraindications. Drug intolerance.
Equipment. Pipette, cotton ball.
Instructions for the patient before the procedure.
Raise your chin and fix your gaze upward and inward.
Technique. Typically, eye drops are instilled into the lower conjunctival fornix when the lower eyelid is pulled back with a cotton ball and the eyeball is deviated upward and inward. It is preferable to instill drops into the outer canthus. It is necessary to ensure that the drops do not fall on the cornea - the most sensitive part of the eye. The cotton ball absorbs excess medication, preventing it from running down the patient's face. You can also instill drops into the upper half of the eyeball - with the upper eyelid and when the patient looks down. When instilling strong drugs (for example, atropine) into the eyes to avoid getting them into the nasal cavity and to reduce general action should index finger apply pressure to the area of the tear ducts for one minute.
Possible complications. Allergic reaction for the drug. If the manipulation is carried out carelessly, damage to the conjunctiva or cornea may occur.
Examination of the visual field (peripheral vision) has great importance for diagnosis and evaluation of treatment results for many eye diseases associated with damage to the retina and optic nerve, as well as the central nervous system (retinal detachment, glaucoma, neuritis optic nerve, damage to the visual pathways and centers).
There are control and instrumental methods for determining the field of view. The visual field is always examined separately for each eye.
The control method is very simple and does not require special devices, the only requirement is that the boundaries of the field of vision of the examiner are normal. The technique is as follows: the doctor sits opposite the patient, the patient covers his left eye with his palm, and the doctor covers his right eye and look into each other’s eyes (the distance between the heads is about 50 cm). The doctor moves moving fingers or some other object from different sides (from the periphery to the center) at the same distance between himself and the patient. With normal boundaries of the visual field, the doctor and patient note the appearance of the object simultaneously.
Instrumental methods include perimetry. The most common is the Förster perimeter, which is a moving dark arc with a radius of curvature of 33 cm. The patient is blindfolded with one eye, he places his chin on a special stand so that the eye being examined is opposite the white point located in the center of the perimeter arc. A fixed white object measuring 0.5 - 1.0 cm, located at the end of a dark stick, is moved along a perimeter arc from the periphery to the center. First, the boundaries of the visual field are determined in the horizontal meridian (outside and inside), then in the vertical meridian (above and below) and in two oblique meridians. When examining the visual field from above, you must always lift the patient's upper eyelid with your finger, otherwise the data may be underestimated. At first, for control, the object can be moved quickly to determine the approximate boundaries, and the second time more slowly (at a speed of 2-3 cm per second). The degrees are indicated on the perimeter arc, which are transferred to a special bank.
Normal boundaries of the visual field White color the following: outside and below-outside - 90, below and inside - 60, below-inside - 60, above and above-inside - 55, above - outside - 70
The boundaries of the visual field are summed up along 8 meridians. Normally, the total field of view for each eye is 520-540. Test the visual field of both eyes on each other using the control method and using the perimeter.
A more accurate study of the field of view is carried out on projection perimeters of various types. To study visual field defects in its central parts, the campimetry method is used, but since this technique is labor-intensive and time-consuming, it is used only in a hospital setting.
Task No. 5: instillation of eye drops, application of ointments, application of monocular and binocular bandages, stickers on the eye.
Instillation of eye drops is one of the common methods of treating eye diseases. The procedure is simple, but requires certain skills. Methodology: Take drops with a 30% solution of Albucid (Sodium Sulfacyl), put the solution into a pipette, take a damp cotton swab (ball) in your left hand, pull the patient’s lower eyelid with it, bring the pipette to eyeball and, without touching the eyelashes and eyes, drop 1-2 drops of Albucid solution into the inner corner of the lower conjunctival fornix. After instillation, press the projection site of the inferior lacrimal punctum with a ball.
ATTENTION: Before putting anything into your eyes, carefully read the name of the drug and the expiration date. Only eye drops can be put into the eye!
Laying ointments. Take a tube of one of the eye ointments (for example, tetracycline), squeeze a little ointment onto the flat surface of a glass rod, pull back the lower eyelid, insert the glass rod with ointment into the lower conjunctival fornix from the outside and ask the patient to close the eyelids, then remove the stick from the under the eyelid All the ointment remains in the conjunctival cavity, evenly distributed there. Remove excess ointment on the skin of the eyelid with a damp cotton swab (ball).
ATTENTION: Only ophthalmic ointment can be placed into the conjunctival cavity!
Bandage over one eye. For the bandage, bandages 6-7 cm wide are used. When applying a bandage to the right eye, hold the head of the bandage in the right hand and bandage from left to right; when applying a bandage to the left eye, it is more convenient to hold the head of the bandage in the left hand and bandage from right to left. The bandage is secured in a horizontal circular motion across the forehead, then lowered down to the back of the head, passed under the ear on the sore side, closing the eye, and secured in a circular motion over the head, then an oblique stroke is made again, but slightly higher than the previous one, and so on, alternating oblique and circular tours, cover the entire eye area.
Bandage on both eyes. The bandage is held as usual (the head of the bandage in the right hand), secured in a circular motion across the forehead, then lowered along the crown and forehead and an oblique stroke is made from top to bottom, covering the left eye, the bandage is carried under right ear, and then make an oblique move from bottom to top, closing the right eye. These and all subsequent moves of the bandage intersect at the bridge of the nose
The bandage is strengthened by moving the bandage in a circular manner across the forehead.
As with a monocular bandage, it is advisable to make a knot in the front or in front - on the side; to do this, tie the end of the bandage to the beginning.
Eye sticker. Cut two strips of adhesive plaster 8-10 cm long and 1 cm wide, place a clean cotton-gauze circle over the eye and secure it with strips of adhesive plaster to the skin of the face crosswise or parallel obliquely (skin of the forehead and cheeks).
Make sure your dressings look neat and aesthetically pleasing!
Characteristics of the implementation technique: simple medical services Algorithm for placing an injection under the conjunctiva I. Preparation for the procedure: 1. Identify the patient based on medical documentation. 2. Introduce yourself to the patient, explain the purpose and course of the upcoming procedure. Obtain his consent to the upcoming procedure. 3. Find out from the patient allergy history. If you have an allergy, consult your doctor. 4. Warn the patient about possible sensations in the eye after the injection* (tingling, pain, burning, excessive tearing, discomfort). 5. Place the patient on a chair (couch) facing the light source. 6. Prepare the medicine: check the expiration date; appearance; name and compliance of the medicinal product with the doctor’s prescription; specify the dosage. 7. Prepare the syringe and consumables: check for leaks; best before date; 8. Carry out hand hygiene. 9. Put on gloves. 10. Drop anesthetic eye drops into the conjunctival sac 2-3 times at intervals of 1-2 minutes. 11. Place the used pipette in the EDPO container. 12. Place the used cotton ball in a container with disinfectant solution for | Class B waste. 13. The ampoule has medicine file the neck, treat it with a sterile alcohol wipe and break off the sawn-off tip of the ampoule. 14. Place the used alcohol wipe with a glass tip from the ampoule in a container for class “A” waste. 15. Open the package with a sterile syringe, put on the needle, remove the protective cap from the needle. 16. Place the used syringe packaging in a container for class “A” waste. 17. Draw the medicine from the ampoule into a syringe in the dose prescribed by the doctor. To do this: - take the ampoule in your left hand, the syringe in your right; without touching the edges of the ampoule, insert the needle; take the prescribed dose medicine; remove air and 1-2 drops of the medicine from the syringe cavity. II Performing the procedure: 18 Ask the patient to tilt his head back and look up and pull the lower eyelid with the index finger of his own hand. 19 Take sterile eye tweezers in your left hand and, at the junction of the conjunctiva with the fornix, pull the conjunctiva towards you in the form of a fold. 20. Right hand take a syringe and inject a needle into the base of the fold of the conjunctiva strictly parallel to the eyeball (along the sclera) to a depth of 2-4 mm. 21. Inject the drug, but not more than 0.5 mm (at the time of drug administration, a drug “cushion” is formed under the conjunctiva), and then remove the needle. III. End of the procedure: 22. Blot the tear with a sterile cotton ball. 23. Place the used tweezers in the EDPO container. 24. Place the used cotton ball in a container with a disinfectant solution for class “B” waste. 25. Separate the needle from the syringe using a special container for class “B” waste with a needle remover. 26. Place the used syringe in the EDPO container 27. Remove gloves and place them in a container with a disinfectant solution for class “B” waste. 28. Carry out hand hygiene. 29. Register the completed procedure in the accounting documentation.
