Assisting individuals with eye care

Eye care is part of maintaining a client’s personal hygiene and is usually performed as part of bathing/showering. Generally the normal physiological processes of blinking and tear production maintain the cleanliness of the eyes, along with daily washing. When a client has difficulty in meeting their eye care needs then the nurse may need to assist, particularly if discharges or crusts appear around the eyes. This can usually be removed by gentle eye swabbing, as outlined below.

The client’s ability to see, along with any aids that are used by the client, such as glasses, contact lenses or eye glass, should be considered when assessing an individual’s personal cleansing and dressing needs, and advice should be sought regarding the appropriate methods of cleaning these if unsure.

Removal of contact lenses is a skilled task; if uncertain as to how to proceed it is best to ask the client, relative (if knowledgeable) or other member of the health care team to demonstrate rather than risking damaging the conjunctiva or cornea.

Equipment:
The equipment needed consists of sterile eye-dressing packs, sterile 0.9 per cent sodium chloride, tray for equipment, clinical waste bag and gloves (if risk of contact with blood or body fluids). The procedures and rationales for eye care are given below.

Procedure	Rationale
Explain procedure to client	To gain consent and co-operation
Apply apron and wash hands	To reduce risk of cross-infection
Gather all equipment	Ease of access
Ensure privacy for the client	Maintains dignity
Ensure good light source	To facilitate the procedure
Assist the client into a comfortable position	Client comfort, co-operation and ease of access for the nurse to perform the procedure
Prepare equipment, wash hands	To prevent cross-infection
Cover the client’s chest using the towel from dressing pack	To protect client’s clothing
Instruct client to close their eyes	To reduce the risk of damaging the conjunctiva or cornea
Moisten swab in the solution and gently swab from the inner canthus outwards, using one wipe. Repeat in the same direction until the eye is free from crusts/discharge. Repeat on the other eye, all the time observing the general condition of the eyes	To restore hygiene
If the client has an infection, wash hands before moving from one eye to the other and always swab the non-infected eye first	To decrease the risk of infecting the other eye
If the eye is to be touched to remove a foreign body, a cotton bud should be used	To prevent further injury or abrasion
Gently dry the client’s eyelids	To remove any excess moisture
Remove and dispose of equipment safely	Infection control
Leave the client comfortable. Remove apron and wash hands	To reduce the risk of cross-infection
Evaluate care delivery, document and report any change in client’s condition	Legal requirement
Update care plan as necessary	Promotes continuity of care

If unsure of the client’s care needs or unsure of the procedure it is imperative that a specialist be consulted.