Prescribed eye medication (drops or ointment) • gloves • warm water or normal saline solution • gauze pads • facial tissues • Optional: ocular dressing, personal protective equipment.

Inspect all equipment and supplies. If a product is expired, is defective, or has compromised integrity, remove it from patient use, label it as expired or defective, and report the expiration or defect, as directed by your facility. Make sure the medication is labeled for ophthalmic use. Date the medication container the first time you open it, because you should use the medication within the time specified by the manufacturer once you’ve opened the container to prevent contamination.^5,6 Follow your facility’s direction or the manufacturer’s instructions on when to discard an opened eye medication. If the tip of an eye ointment tube has crusted, turn the tip on a sterile gauze pad to remove the crust.

• Never touch the tip of the bottle or dropper or the tip of the tube to the patient’s eyeball, lids, or lashes to maintain the drug container’s sterility.¹ If the dropper tip becomes contaminated, discard the medication and obtain another sterile medication bottle.
• Don’t use eye medication for more than one patient, if possible, to prevent cross-contamination; however, if permitted by your facility, you may use preserved multidose eyedrop medications in multiple patients with special infection prevention and patient safety precautions.³⁸

NURSING ALERT Don’t use multidose eyedrops for a patient when you’ve used them to treat another infectious or immunocompromised patient. ³⁸

NURSING ALERT Discard eyedrops immediately if contamination occurs-for example, if the dropper tip touches any part of the eye structure or surface, a staff member administering the medication touches the dropper tip, an open eyedrop container has no expiration date on it, an open eyedrop container has an expiration date that exceeds 28 days, or an eyedrop container is uncapped.³⁸

NURSING ALERT To prevent cross-contamination, never use a container of eye medication for more than one patient.²

• If you’re administering eyedrops and an eye ointment, administer the drops first, because the ointment may inhibit the action of the eyedrops.² Wait times between applications vary; follow the manufacturer’s prescribing information.³⁹
• Treat only the affected eye, unless otherwise ordered.²

If the practitioner has ordered eye medication for home use, teach the patient and family (if appropriate) proper administration technique. Review the procedure, and ask for a return demonstration. Ensure that the patient has refrigeration to store the medication, if necessary . Instruct the patient to contact the practitioner if the desired medication effects don’t occur within an indicated time frame, or if eye irritation or changes in vision develop. Remind the patient and family (if appropriate) not to share ophthalmic medications to prevent cross-contamination, and teach them about the importance of hand washing before and after administration.

Instillation of some eye medications may cause transient burning, itching, and redness. Rarely, systemic effects may occur.

Document your assessment of the eye. Record the medication you administered, eye or eyes you treated, and date, time, and dose, according to your facility’s documentation format. Note the patient’s response to the procedure. Document any adverse effects that occur, the date and time you notified the practitioner, prescribed interventions, and the patient’s response to those interventions. Document teaching you provided to the patient and family (if appropriate), their understanding of that teaching, and any need for follow-up teaching.