Eyedrops: The Easy Way

Posted by Nurse Linda in Life After Paralysis on November 04, 2021 # Health

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.

close up of someone's brown eyeMany 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.

If you need to put your drops in using one hand, doing something similar to the bottle opening with one hand is possible. In this case, use your small finger to create the pouch in your lower eyelid. When looking away, use your thumb and index finger to squeeze the bottle to put in the drops. This becomes easier with practice.

Be very careful not to touch the eye drop bottle to your eyeball, pouch, eyelid or lashes. Not only does that hurt, but it can also introduce infection or cut your cornea. Also, if the eyedrop bottle touches anything, you have contaminated the bottle (much like a catheter touching any part of your body except the urethra). Some people will get two bottles, especially if using over-the-counter eye drops. Remember to mark one bottle ‘R’ for the right eye and one ‘L’ for the left eye. Mark the bottle, not the cap, like those, can become mixed up. This way, if you have an infection in one eye, it will not accidentally travel to the other.

When finished, be sure to put the cap back on the bottle. If it is difficult to remove, there is a temptation to just let the bottle sit open. However, bacteria can form on the bottle, so it must always be covered with the lid.

If you need to wipe your eye for any reason, use clean tissue. Gently dap your closed eyelids. Then discard the tissue. Use a separate tissue for each eye.

Moving away from eyedrops for a moment, what if you get something in your eye? To remove something in your eye, be sure to use this procedure. With your eyes closed, gently wipe from the outer corner of your eye toward the nose. If something is lodged behind the eyelid, like an eyelash, it will come out easier using this technique due to the anatomy of the eye. If something is in your eye, like a small piece of metal or something that will hurt your eye, go to your ophthalmologist or urgent care for removal. You do not want to damage your eye trying to get something out. They will flush your eye with a sterile solution, or sometimes, they will roll your upper lid over a cotton swab and gently remove the particle.

Eyecare is critical to maintaining your health. Be kind to your eyes. Have regular eye appointments. Diseases of the eyes can be diagnosed early. Early diagnosis leads to better outcomes. Nurse Linda

Pediatric Consideration:

Children are not different from adults when it comes to eye drops. Having them instilled incorrectly can lead to trauma and future fear of getting more drops. Be gentle with putting in drops so the child will learn there is nothing to fear. Wiggling children can be a challenge to sit still long enough to accomplish the mission. Distraction by holding a soft toy helps. Pretending to give eye drops to a superhero toy first gives the child an idea of what is going to occur. Younger children might be swaddled.

It is not that unusual for children to get eyedrops, especially for infections such as pink eye. This is quite contagious, so you want to be extremely careful with your handwashing hygiene. Also, use extreme care, so the infection does not travel to the other eye. Keep the tip of the eye drop bottle from touching the eye, eyelid, or lash. Wash your and your child’s hand frequently. Dispose of soiled tissues immediately. Never use a tissue twice. Nurse Linda

Linda Schultz is a leader, teacher, and provider of rehabilitation nursing for over 30 years. In fact, Nurse Linda worked closely with Christopher Reeve on his recovery and has been advocating for the Reeve Foundation ever since.

In our community, Nurse Linda is a blogger where she focuses on contributing functional advice, providing the "how-to" on integrating various healthcare improvements into daily life, and answering your specific questions. Read her blogs here.

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The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.