Introduction
Application of an eye patch, eye shield, or pressure dressing helps in protecting the eyes of an anesthetized.
Purposes
- To keep an eye at rest.
- To prevent the patient from touching his/her eye.
- To absorb secretions (patch and pressure dressing).
- To protect the eye (patch, shield, and dressing).
- To control or lessen edema (pressure dressing).
- To prevent accidental damage to an anesthetized eye (patch, shield dressing).
- To promote healing.
- To prevent corneal ulceration.
- To control hemorrhage from traumatic injury.
Indications
- Hemorrhage.
- Corneal abrasions.
- Anesthetized eye.
- Unconscious patients.
Articles
| Articles | Purpose |
| Eye patches | To protect the eyes. |
| Transparent or adhesive tape | To secure the dressing. |
| Sterile gloves | To maintain asepsis. |
| Scissors | To cut the dressing material/tape. |
| Gauze packs | To dress the eye. |
| Plastic or metal shield | To protect the eye. |
Procedure
| Nursing Action | Rationale | |
| Eye patch | ||
| 1. | Instruct the patient to close both eyes. | To close only the affected eye is difficult. |
| 2. | Place patch over the affected eye. | To protect the eye from injury. |
| 3. | Secure the patch with tape from midforehead to below ear. | Prevents escape of the patch. |
| 4. | For an unconscious patient, moisten the eye patch. | Dry patch can irritate cornea. |
| Eye shield (plastic or metal) | ||
| 5. | Apply eye shield over dressings or directly over the eye. | To protect the eye. |
| 6. | Fasten with special transparent tape. Use two strips. | To prevent escape of the shield. |
| 7. | For metal eye shields, a guard can be placed around flanged edges before use. | This eliminates the need for adhesive tape around the edge. |
| 8. | Stretch it around the perimeter of shield. | Adds cushioning and provides comfort to the patient. |
| Pressure dressings | ||
| 9. | Prepare 8-10 adhesive strips of 2.5 cm length. | Using a strip dressing will improve its adhesiveness. |
| 10. | Paint forehead with tincture benzoin compound. | To promote adherence of tape and prevent excoriation of skin. |
| 11. | Apply two eye patches to the affected eye. | For a bulk pressure dressing. |
| 12. | Apply strips from forehead over unpatched eye across dressings to cheek bone (maxillary prominence). | To secure dressing and to permit freedom of movement of the head. |
| 13. | Remove the eye patch every 4 hours or as per order. | To relieve the pressure over the eyes. |
| 14. | Assess the eye frequently for drainage, irritation, and any lesions. | Indicates infection. |
| 15. | Inform physician if there are any signs of infection. | To initiate prompt action. |
Special Considerations
- Address anxiety or fear of vision loss offer reassurance and emotional support.
- Discuss temporary vision changes post-surgery to set realistic expectations.
- Identify and manage anticoagulants or antiplatelets (e.g., warfarin, aspirin) per surgeon’s protocol.
- Review glaucoma medications some may be continued or adjusted.
- Instruct on preoperative eye hygiene (e.g., lid scrubs, antibiotic drops).
- Emphasize hand hygiene and avoidance of eye rubbing.
- Confirm correct eye and procedure mark per institutional protocol.
- Follow fasting guidelines if sedation or general anesthesia is planned.
- Assess for diabetes, hypertension, or respiratory issues that may affect anesthesia or healing.
- Apply eye shield or patch as ordered especially during sleep.
- For retinal surgeries (e.g., gas bubble placement), maintain specific head positioning to aid healing.
- Administer prescribed eye drops (antibiotics, steroids, NSAIDs) with proper technique.
- Space drops appropriately and avoid contamination of the bottle tip.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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