Voices From The Community | Spinal Cord Injury & Paralysis

Eyedrops: The Easy Way

Written by Nurse Linda | Nov 4, 2021 4:00:00 AM

Often, I see people really struggling to give themselves eye drops. It can be a challenge because your eye is protected by the blink response to stop you from putting anything in it or on it. There are techniques for giving eyedrops that can make this process easier and less distressing. Instilling eye drops is something that can be done without much annoyance.

Many individuals use over-the-counter eye drops for red-eye or dry eyes. These drops can make your eyes feel lubricated. For others, prescription eye drops are necessary for eye conditions such as dry eye, glaucoma, or after eye surgery. If you have had a stroke, brain injury, or damage to facial nerves, you may need eye drops to keep your eye lubricated especially if you cannot close the eyelid completely.

One of the first issues is to grip that tiny bottle. Eye drops and eye medication always come in little containers because you do not need much, just a few drops at a time. Holding something so small can be a challenge if your grip is weak. You can help by wrapping a small rubber band around the base of the eye drop bottle. That can keep your grip more secure on the bottle.

Opening the bottle can be a challenge. You may need some assistance in getting the bottle out of the packaging. We all could use help with some of the tamperproof packaging that keeps us safe. If you have someone help you get the eye drop bottle out of tamperproof packaging, be sure they wash their hands before touching it, even just in getting the bottle out of the wrapper. Eye drops are sterile. Contamination of the bottle is easy. You do not want that contaminate to get into your eye drops and into your eye.

In protecting your eyes and vision, be sure you or whoever is putting in your eyedrops wash their hands first, just prior to administration. This is important to your health and safety. Good handwashing starts with wetting your hands first so the soap can adhere to the germs. Be liberal with the soap. Rub your hands together for 20 seconds, or the time it takes to sing happy birthday twice. Wash in between the fingers and later up the nail area. Rinse well. Hand washing should be just like the COVID handwashing technique, which we all have become proficient in doing.

To get the bottle open using one hand, secure the bottle using your ring and small fingers against your palm. Then see if you can grasp the cap with your thumb and index finger on the same hand. If you have some dexterity, you will be able to twist the cap off and, when finished, twist it back on. This works well for individuals who, for example, have had a stroke as one hand function can be nimble.

If you have a spinal cord injury, you may need more support to twist open the cap. Using a small tong or tweezer can help. There are ‘grab its’ used in the kitchen to open jars that will work to mold around the bottle top to apply some grip to assist in twisting off the bottle top. You might also try rolling the bottle top across the grab it while it is flat on a counter or table. Hold the bottle securely but roll just the cap on the grab it. The cap usually has some texture to help open the bottle. This texture can be used to work against the grab it to open the bottle. Be careful not to squeeze the bottle as you roll to avoid losing the eyedrop fluid.

In keeping the eye drop fluid as sterile as possible, avoid using your mouth to open the bottle. That is the go-to for many things when hand function is a concern; however, what you put in your eye should be sterile. You do not want to get an infection from a tainted eye drop solution. The mouth is part of the gastrointestinal system, which is not sterile. Avoid contamination by not using your mouth.

Once the bottle is open, you are ready to put in the eyedrops. People have developed their eye drop insertion method, which does more harm than good. Some are taught this incorrect method of instilling eye drops. Videos online have demonstrations of this possibly harmful positioning. Many individuals throw their heads back and drop the eyedrop right into the center of the eye. How they do, this is amazing because the blink reflex is going to kick in as a natural response to a threat to the eye. Looking at the eyedrop heading into your eyeball makes this response stronger. Throwing your head back stretches the blood vessels in your neck, which can lead to a stroke as well as disrupt the muscles in the neck and over flexing the vertebrae (neck bones). You may have had neck stabilization surgery that stops you from putting your neck back or is not recommended for your specific condition.

There is an easier way to instill eye drops with the benefit of not traumatizing yourself. When putting in eye drops, you do not need to extend your neck backward. Keep your head positioned as normal. If someone is putting the eye drop in for you, leaning back a little but keep your head in alignment with your torso. This can be accomplished in a tilting powerchair. Be sure to keep your neck in alignment. Overextending your neck is not great for your body and is unnecessary in the eye drop process. You may have rods in your neck which prevent this movement, an unstable spine or hidden blood clots leading to another stroke. So, you can see positioning your head upright is important.

To put in the eye drops, use one hand to pull down the lower lid near the outer corner of your eye. This will create a little pouch between your lower eyelid and eyeball. Put the eye drop bottle close to the pouch but not touching it. Use a mirror if needed. Once in position, look away from the bottle. If putting drops in the right eye, look to the left. Drops in the left eye, look to the right. You will not see the drops coming toward your eye, so your blink reflex will not be activated. Add a tiny bit of pressure to the bottle. You will feel the drop hit inside the pouch. The cool temperature of the eye drop might startle you just a tad, but your blink reflex will not be strong because you cannot see the drop. Count the number of drops as prescribed, then release the pouch. If using more than one drop, put in each drop slowly so you can count them correctly. The eye drops will surround your eye as soon as you release your lower eyelid and blink. The only thing shocking about this process is how simple it is. Like everything, it takes just a time or two to get the hang of it. Avoiding the trauma of overcoming the blink reflex is removed.