Page 1 of 2 Eye Care Adults Cleansing the eyelids Demonstrated by Lynn Ring, Ophthalmic Nurse Specialist, Epsom & St Helier University Hospitals NHS Trust ©2015 Clinical Skills Limited. All rights reserved Ocular hygiene is a significant part of nursing care. It should be part of daily personal hygiene, when carrying out bed baths or assisting with washing, as well as when a patient complains of eye discomfort. It is important to clean both the upper and the lower eyelids to ensure that the patient gains maximum relief from symptoms. The frequency of care will depend on symptoms and patient preference. In patients who are sedated or unconscious, ensure that the eyelids are fully closed, to avoid exposure damage to the cornea. Eyes that feel sore, itchy or gritty are a common complaint. Causes include: • Poor sleep. • Tear film dysfunction (dry eye). Patients may report sore eyes upon waking, with symptoms that worsen during the day. The symptoms may include pain, a burning sensation and a red eye (Shaw et al., 2010). • Blepharitis (a disorder of the eyelid margins). It usually affects both eyes and is chronic in nature. It occurs particularly in elderly people or young people with autoimmune disease (Pane & Simcock, 2005). It often causes crusting around the lash margins and stickiness when waking, as well as a red eye. • Conjunctivitis, which may be viral, allergic or bacterial. The symptoms may include a feeling of grittiness, itchiness, discharge and red eye. • Eye surgery, such as that to remove a cataract. Patients who have had eye surgery will have been given instructions about when and how to cleanse their eyelids; health professionals, patients and carers alike need to follow these instructions. Regardless of the cause, eyes that feel irritable can be distressing, as the natural tendency to rub the affected eye(s) can cause further damage. Equipment Obtain an eye dressing pack or an ordinary dressing pack, and sterile normal saline. Cotton buds may be used to remove crusted debris (follow local policy). This procedure shows use of a clean technique to cleanse the eyelids. Do not undertake or attempt any procedure unless you are, or have supervision from, a properly trained, experienced and competent person. Always first explain the procedure to the patient and obtain his/her consent, in line with the policies of your employer or educational institution Assess the eyelids. Check for inflammation, crusting and/or thick discharge. Does the eye itself look red? Take care not to touch the globe of the eye itself, particularly the cornea, to avoid accidental damage. As appropriate, you may need to carry out a full external examination of the eyes (see clinicalskills.net procedure on External examination of the eyes). Explain the procedure to the patient and obtain informed consent. Ensure privacy. You will need a good light source, so that you will be able to see any minute particles. Avoid shining the light into the patient’s eyes; illuminate the eyes by directing the light to the side of the eye or just below the nose. Ask the patient to remove any spectacles or contact lenses. Assess the patient Prepare your patient: obtain consent S T E RILE R S TERILE R CONT: 50 X E CM FLN/WHT PAPER. 50X45CM DRESSING TOWEL EYE D R E S S I NG PACK REF: RML 101 - 514 REV B( 1715SHTO8L) MEDIU M L A T EX FREE EX/GLOVES.10. EX5CM 4FLY N/W/SWABS 1 GALLIPOT TRA V = 912 52 9 = ==10/2009==10 2012 1 : YELLOW BAG L OT : : : D O N OT USE IF P A C K O PE NORDAMAGED SINGLE USE ONLY 2 DONOT US E IFPACK O P ENORDAMAGED SINGLE USE O NLY 2 LOT : : : 25ml sterile topical irrigation solution containing 0.9%wv Sodium Chloride Ph. Eur. NOT FOR INJECTION DISCARD ANY UNUSED SOLUTION STORE BELOW 25ϒC IN ORIGINAL CONTAINER OUT OF DIRECT SUNLIGHT FOR THE TOPICAL IRRIGATION OF EYES, BURNS AND WOUNDS INCOMPATIBLE CHEMICALLY WITH SILVER, LEAD AND MERCURY 0120 STERILE STERETS Normasol