Ophthalmology Book


Instilling Eye Drops

Aka: Instilling Eye Drops, Don't Open Eyes Technique for Eye Drop Instillation, DOT for Topical Ophthalmic, Eye Drop Technique
  1. See Also
    1. Topical Eye Preparation
  2. Precautions
    1. Proper use of eye drops prevents systemic absorption, inaccurate dosing and medication waste
    2. Avoid touching dropper tip to eye (avoids bottle contamination)
    3. Wait at least 5 minutes before instilling another drop of the same or a different agent
      1. Allows for maximal concentration delivery of each medication drop without dilution
      2. Alternatively, may stagger medications at different times of day
    4. Instill medications in order of least viscous first
      1. Solutions first
      2. Suspensions or gels
      3. Ointments last
  3. Technique: Standard Technique
    1. Method 1
      1. Patient tilts head back
      2. Pull downward on lower lid to create a pocket to hold medication
      3. Look up before instilling drops
    2. Method 2
      1. Patient lies supine
      2. With eyes closed, instill a drop at the medial canthus
      3. Slowly open the eye and allow the medication to drop into eye
    3. Adjunctive
      1. Drop guides (e.g. Ezy-Drop) help hold the eye open
      2. Drop adapters (e.g. autosqueeze) help squeeze the bottle
  4. Technique: Don't Open Eyes Technique for Eye Drop Instillation (DOT for Topical Ophthalmic)
    1. Reduces systemic absorption of ophthalmic preparations
      1. Ophthalmic Beta Blockers have been associated with Beta Blocker Toxicity
    2. Method
      1. Instill medication using technique as above
      2. Keep eyes closed for 1-5 minutes following installation of eye drops
      3. Consider also applying pressure at lacrimal ducts to prevent drainage
    3. Mechanism
      1. Keeping eyes closed limits drainage of ophthalmic medication into tear ducts
      2. Medication is more easily systemically absorbed at tear duct
  5. References
    1. (2018) Presc Lett 25(5):28
    2. (2013) Presc Lett 20(7):40

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