OPHTHALMOLOGIC

MANEUVERS
1. OCULAR INSTILLATION, OINTMENT
APPLICATION

If you are using eye ointment, put a thin line of

ointment along the pouch.
 Administering eye drops or eye ointment to someone else
1.Wash your hands with soap and warm water, then dry
them well.
2. Let the patient sit down and tilt his/her head back while
looking up with both eyes.
3. Rest your hand on the patient’s temple while keeping
the bottle above the eye.
4. Using the thumb of your other hand, make a pocket by
pulling the patient’s lower eyelid lower.
5. Squeeze the bottle gently near the eye (about an inch
away) and allow the eye drop fall into the pocket.
6. If you are using eye ointment, squeeze a thin line of
ointment along the pouch.
7. Ask the patient to close his eye gently and press on the
lacrimation duct lightly for a minute. 
8. Wipe any excess drops from the closed eyelid with a
tissue. Repeat the steps with the other eye, if necessary.
9. Wash your hands once you’re done.
 Safety tips
Take these safety precautions when applying eye drops or eye
ointment:
• Never share your eye ointment with anyone else.
• Use your ointment only within the expiry date on the tube, and
discard the bottle after one month once opened. This is to
ensure they are not contaminated or have become less
effective.
• Do not squeeze the tube too hard to avoid overflowing of
ointment.
• Make sure the bottle tip is clean and doesn’t touch your eye,
eyelashes, eyelids, fingers, or any surface. This is to keep
bacteria or other contaminants from growing in your eye.
• If you need to use eye drops and eye ointment, apply the eye
drops first, then wait for five minutes before using the eye
ointment.
• To improve the flow of eye ointment, hold the tube in hand for
several minutes to warm before use.
• It is normal for your vision to be slightly hazy, misty or blurry
after applying the eye drops or eye ointment.
• Please be aware that some eye ointments may sting or irritate
for a while after putting it on. Let your doctor know if the
symptoms worsen or you experience other adverse effects.
2. LAVAGE AND EYE IRRIGATION
Indications
 To remove single or multiple foreign bodies from the eye
 To wash the eye thoroughly following any chemical injury to the eye
 Note: Irrigation of the conjunctival sac is an emergency treatment if there has been
chemical injury to the eye.
You will need:
 A large syringe or a small receptacle with a pouring spout, such as a feeding cup
 Irrigating fluid (normal saline or clean water at room temperature)
 Local anaesthetic eye drops
 Towel or gauze swabs
 Lid retractors if available
 A bowl or kidney dish
Method
 Instil local anaesthetic eye drops.
 With the patient lying down, protect the neck and shoulders with a towel or sheet.
 Place the bowl or kidney dish against the cheek, on the affected side, with the head tilted
sideways towards it.
 Fill the feeding cup or syringe with the irrigating fluid and test the temperature on your
hand.
 Ask the patient to fix his/her gaze ahead.
 Open the eyelids. If necessary, gently use eyelid retractors.
 Pour or syringe the fluid slowly and steadily, from no more than 5 centimetres away, onto
the front surface of the eye, inside the lower eyelid and under the upper eyelid.
 If possible, evert the upper eyelid to access all of the upper conjunctival fornix.
 Ask the patient to move the eye in all directions while the irrigation is maintained.
3. UPPER EYELID EVERSION

Indications
• Eyelid Foreign Body Exam
• Examination of superior palpebral conjunctiva
Technique
• Patient looks down with both eyes open
• Depress the mid-portion of upper lid laterally
• Use Cotton swab or other blunt instrument
• Grasp the lashes of the upper lid and lift
upward
• Upper lid remains relaxed while patient looks
downward