General Nursing (RGN)
Instillation of Eye Drops
Eye-drop instillation delivers a prescribed ophthalmic solution into the lower conjunctival sac. The nurse verifies the correct patient, medication, dose and eye, positions the patient safely, prevents dropper contamination, applies punctal occlusion when appropriate and observes the response.
Purpose
- Provide prescribed local ophthalmic treatment
- Irrigate or lubricate the eye when ordered
- Deliver selected diagnostic or local anaesthetic drops
Indications
- A valid prescription for an ophthalmic solution or suspension
- Treatment of an assessed eye condition or prescribed diagnostic procedure
- A patient who can safely cooperate or has appropriate assistance
Equipment
- Prescribed eye drops and medication chart
- Clean tray and sterile gauze or cotton swabs
- Sterile normal saline when cleansing is required
- Disposable gloves when discharge, infection or contact precautions require them
- Tissues, waste receptacle and hand hygiene supplies
Procedure steps
- Verify patient identity, medication, dose, time, expiry, allergies and the correct eye; inspect the bottle and solution.
- Explain the procedure, obtain consent and position the patient sitting or lying with the head supported and slightly extended.
- Perform hand hygiene and apply gloves when indicated; remove discharge from inner to outer canthus using a clean swab for each wipe.
- Ask the patient to look upward, gently pull the lower eyelid down to form the conjunctival sac and avoid pressure on the globe.
- Hold the dropper above the eye without touching the eye, eyelashes, eyelid or any surface.
- Instil the prescribed number of drops into the lower conjunctival sac, then allow the patient to close the eye gently.
- Apply gentle punctal occlusion when clinically appropriate for the medicine and patient, without pressing on the eye.
- If multiple eye medicines are prescribed, allow the required interval between drops and apply ointment after drops when ordered.
- Wipe excess from the skin with clean gauze, remove gloves, perform hand hygiene and dispose of materials safely.
- Observe pain, redness, swelling, vision change, discharge, allergy and tolerance; document the eye treated, response and teaching.
Precautions
- Do not administer to the wrong eye or use a contaminated, expired or cloudy preparation.
- Avoid contact between the dropper and the eye or eyelashes; do not share ophthalmic bottles between patients.
- Use extra care after eye surgery or with injury and follow specialist instructions for pressure or movement restrictions.
- Report severe pain, sudden visual change, facial swelling, breathing difficulty or worsening redness urgently.
Aftercare
- Advise the patient not to rub the eye and to report persistent irritation or blurred vision.
- Store the medicine according to product instructions and keep the cap clean and closed.
Nursing considerations
- Use a separate clean swab for each eye and follow the product's storage and discard instructions.
- Maintain privacy and use communication support when visual or language barriers affect understanding.
Possible complications
- Contamination or eye infection
- Corneal injury from dropper contact
- Allergic or local irritation
- Medication error or transient or serious visual change
Patient education
- Explain the purpose and spacing of multiple ophthalmic medicines and how to avoid touching the dropper tip.
- Tell the patient to report severe pain, worsening vision, swelling, rash or breathing difficulty immediately.
Documentation
- Record medication, dose, time, eye treated, technique, punctal occlusion when used, response and any reaction.
- Document refusal, inability to cooperate, patient teaching and escalation.
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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