When paralysis or coma impairs or eliminates the corneal reflex, frequent eye care aims to keep the exposed cornea moist, preventing ulceration and inflammation. Application of saline-saturated gauze pads over the eyelids moistens the eyes. Commercially available eye ointments and artificial tears also lubricate the corneas, but a doctor's order is required for their use.
Although eye care isn't a sterile procedure, maintain asepsis as much as possible.
Sterile basin 
gloves sterile towel sterile normal saline solution sterile cotton balls mineral oil artificial tears or eye ointment (if ordered) gauze or eye pads hypoallergenic tape.
Assemble the equipment at the patient's bedside. Pour a small amount of saline solution into the basin.
- Wash your hands thoroughly, put on gloves, and tell the patient what you're about to do, even if he's comatose or appears unresponsive.
Clean . . .
- To remove secretions or crusts adhering to the eyelids and eyelashes, first soak a cotton ball in sterile normal saline solution. Then gently wipe the patient's eye with the moistened cotton ball, working from the inner canthus to the outer canthus to prevent debris and fluid from entering the nasolacrimal duct.
- To prevent cross-contamination, use a fresh cotton ball for each wipe until the eye is clean. To prevent irritation, avoid using soap to clean the eyes. Repeat the procedure for the other eye.
. . . and lubricate
- After cleaning the eyes, instill artificial tears or apply eye ointment, as ordered, to keep them moist.
- Close the patient's eyelids. Dab a small amount of mineral oil on each lid to lubricate and protect fragile skin.
- Soak gauze or eye pads in sterile normal saline solution, place them over the eyelids, and secure with hypoallergenic tape. Change gauze pads, as necessary, to keep them well saturated.
Finishing up
- After giving eye care, cover the basin with a sterile towel and dispose of the gloves. Change the basin, towel, and normal saline solution at least daily. (See Documenting eye care.)
Outline