Material preparation: wash hands before operation, check the patient's name, eyes, drug name and concentration, and observe whether the water preparation is discolored or precipitated; Eye drops, dropper (or bottle), sterile cotton swab.
Operation: The patient takes a sitting position or supine position, with his head slightly tilted backward and inclined to the affected side. He pulls the patient's lower eyelid with his left finger or cotton swab, and holds the eyedropper or eyedropper in his right hand, and drops the liquid medicine into the conjunctival sac of the lower fornix at a distance of 1 ~ 2 cm from the eye. Gently lift the upper eyelid with your fingers to make the liquid medicine diffuse in the conjunctival sac. Wipe off the spilled liquid medicine with a cotton swab and let the patient close his eyes 1 ~ 2 minutes.
Objective: to make the drug stay in conjunctival sac for a long time and have a lasting effect. It is generally used for people who need to protect the cornea after surgery, before bandage pressure dressing, eyelid insufficiency, anterior segment diseases and so on.
Material preparation: wash your hands, check the patient's name, eye shape and drug name, and check whether the eye ointment mouth and glass rod are unobstructed; Eye ointment, sterilized round glass rod, sterilized cotton ball.
Operation: The patient's posture is the same as that of eye drops. The operator squeezes the eye ointment with his right hand for a short time, then squeezes the eye ointment into the lower fornix, or dips a little eye ointment with a glass rod, then puts the glass rod and eye ointment flat on the fornix, tells the patient to close his eyes and rotate the glass rod at the same time, then draws it out horizontally, and massages the eyelids to make the eye ointment evenly distributed in the conjunctival sac.
Purpose of subconjunctival injection: To inject drugs into the loose space under the conjunctiva, so as to increase the concentration of drugs in the eyes, enhance and prolong the action time of drugs, and use them for corneal and pigment membrane administration.
Preparation of medication: wash your hands; Check drugs and eye shape; Syringe, No.4 ~ No.6 injection needles, drugs for injection, 0.5% tetracaine solution, antibiotic eye drops, sterilized cotton swabs, gauze eye patches and adhesive tape strips.
Operation: Ask the patient to take a sitting position or supine position, and drip 0.5% tetracaine solution into the affected eye for 3 times (1 time, once every 3 ~ 5 minutes). The operator separates the upper and lower eyelids with his left hand, so that the patient can look in a certain direction, exposing the bulbar conjunctiva at the injection site, holding a syringe filled with liquid medicine in his right hand, using a needle to stir the conjunctiva away from blood vessels, and quickly stabbing people to inject drugs.
Use of retrobulbar injection: used for fundus administration and retrobulbar anesthesia during intraocular surgery.
Preparation of medication: wash your hands; Check drugs and eye shape; Syringe, retrobulbar injection needle, injection drug, 3% tincture of iodine, 75% ethanol, sterile cotton swab, gauze and disinfection tray.
Operation: The patient takes a sitting position or supine position, and routinely disinfects the skin around the eyelid. Ask the patient to look up at the nose, vertically pierce the syringe needle into the skin at the junction of the middle and outer edges of the orbital rim 1/3 about 1 ~ 2 cm, walk along the orbital wall, tilt inward and upward by 30, push the needle between the external rectus muscle and the optic nerve towards the orbital apex, insert the needle for 3 ~ 3.5 cm, and slowly inject the liquid medicine. After pulling out the needle, compress the needle eye 1 min and apply antibiotic eye ointment.
Objective: To remove foreign bodies, acid and alkali chemicals and purulent secretions in conjunctival sac and clean conjunctival sac before operation.
Material preparation: wash your hands; Eye wash pot or eye wash bottle, water reservoir, sterile cotton ball, washing liquid.
Operation: The patient takes a sitting position or supine position, with his head tilted to one side. The water reservoir clings to the cheek of the affected eye. Separate the upper and lower eyelids, rinse the eyelid skin first, and then rinse the conjunctival sac. Turn your eyelids when washing the upper fornix and ask the patient to look down. When flushing the lower fornix, ask the patient to look up. At the same time, turn your eyes in all directions, gently push your eyelids, fully wash all parts of the conjunctiva, and wipe your eyelids and cheeks with cotton balls.
Objective: To diagnose lacrimal duct diseases, rinse lacrimal duct secretions and clean lacrimal duct before operation.
Preparation of medication: wash your hands; Check the patient's name and eye shape; Syringe, lacrimal irrigation needle, lacrimal punctum dilator, water receiver, tetracaine solution, irrigation solution and cotton swab.
Operation: Let the patient sit or lie down, press the lacrimal sac to squeeze out the secretion, then put the tetracaine cotton swab between the upper and lower lacrimal punctum and close your eyes for 3 minutes. Gently pull down the eyelid with your left hand and ask the patient to look up. Hold the syringe in your right hand and insert the needle vertically into the lacrimal punctum about 1 ~ 1.5 mm, then rotate horizontally and extend inward about 5 ~ 6 mm, and inject the washing liquid.
Objective: To clean and disinfect the surgical field before intraocular surgery to prevent eyelashes from falling into the eyes.
Preparation of medication: wash your hands; Check the patient's name and eye shape; Small blunt scissors, eye ointment or vaseline and gauze.
Operation: The patient is seated. First, apply a layer of vaseline or eye ointment to the two leaves of scissors and stick the cut eyelashes. When cutting the eyelid eyelashes, let the patient bow his head and press the upper eyelid skin with his fingers to make the eyelid edge slightly everted; When cutting eyelashes, look up and press the eyelid skin with your fingers to make the lower eyelid slightly everted, thus cutting off the upper and lower eyelashes respectively. Clean the cut eyelashes with gauze to prevent them from falling into the conjunctival sac.
Hot compress and eye care hot compress aim at promoting local blood circulation, diminishing inflammation and relieving pain, and promoting absorption.
Preparation of medicine: dressing bowl or thermos cup, tweezers, some sterilized gauze, vaseline, eye ointment, cotton pad, hot water, traditional Chinese medicine decoction or other hot compress liquid containing medicine.
Operation: first apply a layer of vaseline ointment to eyelid and surrounding skin, apply eye ointment to conjunctival sac to close eyes, and cover it with sterile gauze. Use tweezers to wring out the gauze pad soaked in hot water at 45 ~ 50℃, apply it on the sterilized gauze of eyelid, and then cover it with cotton pad to keep warm. The gauze pad should be replaced every 3 ~ 5 minutes and applied for 20 ~ 30 minutes. Pour the boiled traditional Chinese medicine fumigant or boiled water into a small thermos bottle or thermos cup, and let the patient bow his head close to the affected eye. The distance from the eyes to the bottle mouth is subject to the heat that the patient can bear, and each fumigation time is 15 ~ 20 minutes.
Use of eye pad: used for corneal ulcer, after eye surgery or trauma, eyelid insufficiency, etc. Protect the wound, prevent infection, and let the eyeball get a full rest.
Drug preparation: eye pad, eye ointment, sterilized cotton ball and adhesive tape.
Operation: Apply eye ointment, disinfect eyelid skin, cover eye pad, and fix 2 pieces obliquely from the upper edge of nose and orbit to the lower edge of temporal orbit with adhesive tape, and add 1 piece horizontally if necessary.
Objective: To prevent exposure keratitis by wet chamber method.
Preparation of medication: transparent film, antibiotic eye drops, eye ointment and adhesive tape.
Operation: Drop antibiotic eye drops and ointment into the affected eye, make the transparent film into a hemispherical or funnel-shaped shell cover, cover it on the affected eye and seal it with adhesive tape.
The purpose of eye dressing method is to fix the dressing firmly; Local compression plays a role in stopping bleeding; For patients with shallow anterior chamber after operation, local pressure dressing was used to promote the formation of anterior chamber; Prevent corneal ulcer perforation; After partial eye surgery, reduce eye activity and local reaction.
Preparation of medication: wash your hands; Check the patient's name and eye shape; Narrow bandage (6 meters long and 4.8 centimeters wide), eye ointment, eye pad and adhesive tape.
Operation: monocular bandage method; Binocular bandage
How to take out corneal foreign body with minor surgery commonly used in ophthalmology Objective: To take out corneal foreign body.
Indications: corneal foreign body injury.
Preparation of medication: wash your hands; Check the patient's name and eye shape; 1% tetracaine, foreign body knife, antibiotic eye drops, eye ointment.
Operation: Take the patient to supine position and explain how to cooperate. Use 1% tetracaine for surface anesthesia for 2 ~ 3 times. Open the eyelid of the affected eye and ask the patient to look straight in a certain direction with his eyes fixed, and don't roll his eyes. For superficial foreign bodies, you can wipe them with a wet cotton swab dipped in antibiotic eye drops. For corneal foreign bodies that cannot be erased, hold a foreign body knife at 15, gently insert the foreign body edge, and take out the foreign body toward the corneal edge to avoid damaging the cornea.
Objective: To expel pus and diminish inflammation.
Indications: mature external and internal blepharitis.
Material preparation: sharp blade, drainage strip, sterile gloves, sterile tweezers, eye mask, adhesive tape and antibiotic eye ointment.
Operation: The patient takes supine position. Anesthesia is not needed when removing external blepharitis. After local disinfection, fix the eyelid skin on both sides of the lesion with the fingers of the left hand, and cut the skin at the pus point parallel to the eyelid margin with a sharp blade in the position with low fluctuation, and drain the pus and wipe it with a cotton swab. If the pus is sticky after incision and it is difficult to be discharged naturally, tweezers can be used to open the pus cavity and discharge the pus. If the abscess is large and there is more pus, a drainage strip should be placed. When cutting open the inner palpebral adenitis, anesthetize the drug surface first, then turn over the eyelid and fix the palpebral margin with the thumb of the left hand. Aim a sharp knife at the vertical direction of the pus point and eyelid margin, cut the eyelid conjunctiva at the pus point to make pus flow out, and wipe it with a sterile cotton swab.
Objective: To remove meibomian gland cyst.
Indications: Large or perforated meibomian gland cyst.
Materials preparation: meibomian gland cyst clip, small curette, sharp blade, straight tooth forceps, straight scissors, eye ointment, 1% tetracaine solution, local anesthetic, cotton pad, eye pad and adhesive tape.
Operation: the patient was supine, local routine disinfection and local infiltration anesthesia; Place the ring surface of meibomian gland cyst clip on the conjunctiva of eyelid to fix the cyst, turn the eyelid, cut the cyst wall with a sharp knife perpendicular to the eyelid edge, scrape off the contents of the cyst cavity with a small scraper, and then separate and cut the cyst wall as completely as possible with a small scissors.
The purpose of trichiasis electrolysis is to electrolyze water and salt in tissues by direct current, generate sodium hydroxide and heat, and destroy hair follicles so that they no longer grow.
Indications: A few trichiasis have no inversion.
Material preparation: syringe, needle, eyelash pliers, electrolyzer, local anesthetic and sterilized cotton ball.
Operation: The patient was supine, and local routine disinfection and anesthesia were performed. After checking that there is no abnormality, the electrolyzer can be used. Wrap the copper sheet of the anode with physiological saline gauze and stick it on the affected skin. Insert the needle connected to the cathode into the root of eyelashes for about 2mm and apply electricity for about 10 second. When the hair follicle turns white, pull out the needle, gently pull out the eyelashes with eyelash tweezers, and apply antibiotic eye ointment to cover the eyes 1 day.