Procedure for Eye Irrigation

Objective: To flush eye(s) with solution to remove secretion and foreign bodies, or to dilute chemicals.

Indication: Secretion, chemicals, or foreign bodies in the eyes.

Contraindications: None

Nursing Alert: When irrigating both eyes, have the patient tilt his head toward the side being irrigated to avoid cross-contamination. For chemical burns, irrigate each eye with at least 1000 ml of normal saline solutions.

Charting: Document the date, time, and duration of irrigation and the type and amount of solution.

After Care:
a.Discard equipment in appropriate area.
b.Wash your hands

Equipment: Sterile irrigating solution warmed to 37 C (98.6 F), disposable gloves (optional), cotton balls, sterile irrigating set (sterile container and irrigating or bulb syringe), emesis basin or irrigation basin, waterproof pad, towel

ACTIONS:

1.Explain procedure to the client
Rationale: Explain facilitates cooperation and provides reassurance for the client.

2.Assemble equipment.
Rationale: This provides for an organized approach to the task.

3.Wash your hands
Rationale: Handwashing deters the spread of microorganisms.

4.Have the client sit or lie with the head tilted toward the side of the affected eye. Protect the client and the bed with  waterproof pad.
Rationale: Gravity will aid the flow of solution away from the unaffected eye and from the inner canthus of the affected eye toward the outer canthus.

5.Don disposable gloves if infection is present. Clean the lids ad the lashes with a cotton ball moistened with normal saline or the solution ordered for the irrigation. Wipe from the inner canthus to the outer canthus. Discard the cotton ball after each wipe.
Rationale: Materials lodged on the lids or in the lashes may be washed into the eye. This cleansing motion protects the nasolacrimal duct an the other eye.

6.Place the curved basin at the cheek on the side of the affected eye to receive the irrigating solution. If sitting up, ask the client to support the basin.
Rationale: Gravity will aid the flow of solution.

7.Expose the lower conjunctival sac and hold the upper lid open with your nondominant hand.
Rationale: The solution is directed onto the lower conjunctival sac because the cornea is very sensitive and easily injured. This also prevents reflex blinking.i

8.Hold the irrigator about 2.5cm(1 inch) from the eye. Direct the flow of the solution from the inner canthus to the outer canthus along the conjunctival sac.
Rationale: This minimizes the risk of injury to the cornea. Solution directed toward the outer canthus helps prevent the spread of contamination from the eye to the lacrimal sac, the lacrimal duct, and the nose.

9.Irrigate until the solution is clear or all of the solution has been used. Use only sufficient force gently to remove secretions from the conjunctiva. Avoid touching any part of the eye with the irrigating tip.
Rationale: Directing solutions with force may cause injury to the tissues of the eye, as well as to the conjunctiva. Touching the eye is uncomfortable for the patient.

10.Have the client close the eye periodically during the procedure.
Rationale: Movement of the when the lids are closed helps move secretions from the upper conjunctival sac to the lower.

11.Dry the area after the irrigation with cotton balls or a gauze sponge. Offer a towel to the client if the face and neck are wet.
Rationale: Leaving the skin moist after an irrigation is uncomfortable for the client.

12.Wash your hands.
Rationale: Handwashing deters the spread of microorganisms.

13.Chart the irrigation, appearance of the eye, drainage, and the client’s response.
Rationale: This provides accurate documentation.


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