What is the proper technique for administering eye ointment?

Proper Technique for Administering Eye Ointment

The most effective way to administer eye ointment is to apply a small ribbon (about 1-2 cm) directly to the lower eyelid margin while gently pulling down the lower lid to create a pocket, then have the patient close their eyes and roll the eyeball to distribute the medication. 1

Step-by-Step Application Technique

Preparation

• Wash hands thoroughly before handling any eye medication to prevent introducing contaminants 2
• Check the medication label to ensure correct medication, dosage, and expiration date 2
• If multiple eye medications are being used, apply eye drops first, then wait 5-10 minutes before applying ointment, as ointment will affect the absorption of eye drops 2

Application Method

• Position the patient either sitting with head tilted back or lying down 1
• Gently pull down the lower eyelid to create a pocket (conjunctival sac) 1
• Squeeze a small ribbon of ointment (1-2 cm) along the inside of the lower eyelid margin, from the inner to outer corner 1, 2
• Avoid touching the eye or eyelid with the tip of the tube to prevent contamination 1
• Have the patient close their eyes gently for 1-2 minutes to allow the ointment to melt and spread across the eye surface 1
• Instruct the patient to roll their eyeballs while keeping the eyes closed to help distribute the medication 1
• Gently blot away any excess ointment from the eyelid or cheek with a clean tissue 2

Special Considerations

Vision Effects

• Warn patients that eye ointments will temporarily blur vision for 15-30 minutes after application 1
• For this reason, ointments are often preferred for nighttime use 1
• If daytime use is necessary, advise patients not to drive or operate machinery until vision clears 1

Patient Populations Requiring Special Attention

• For unconscious patients or those with impaired eye closure, prevention of corneal exposure is essential 1
• In patients with Bell's palsy or other conditions causing incomplete eye closure, eye ointments are particularly beneficial for overnight protection 1
• For children, assistance from a caregiver is typically needed for proper administration 1

Common Pitfalls and How to Avoid Them

• Applying too much ointment: Use only a small ribbon (1-2 cm) to avoid excessive overflow and blurring of vision 1
• Contaminating the tip: Never touch the tip of the tube to any surface, including the eye or eyelid 1
• Incorrect placement: Ensure ointment is placed on the conjunctival surface of the lower lid, not on the cornea directly 1
• Squeezing air bubbles: Gently squeeze the tube to avoid air bubbles that can cause inconsistent dosing 2
• Incomplete distribution: Failure to close eyes and roll eyeballs after application can result in uneven coverage 1

Evidence-Based Benefits of Proper Technique

• Proper application of eye ointment provides longer contact time with the ocular surface compared to eye drops 1
• Eye ointments are particularly effective for overnight treatment due to their longer retention time 1, 3
• Studies show that ointments applied to the lid margin can effectively deliver medication to the ocular surface 4
• Research demonstrates that lipid-based ointments can improve tear film stability and reduce symptoms in dry eye conditions 3

By following these steps carefully, patients can maximize the therapeutic benefits of eye ointment while minimizing potential complications or medication waste.