The document outlines pre-operative and post-operative ophthalmic care, detailing the necessary steps and considerations for both stages of surgery. Key points include obtaining written consent, administering medications, maintaining patient comfort, and specific aftercare instructions to prevent complications. It also emphasizes the importance of patient education and awareness of post-surgery expectations and activities to avoid.

1. Pre & post op ophthalmic care

2. PRE OPERATIVE NURSING CARE

3.  Pre-operative nursing care & treatment varies
with the hospital, the eye surgeon, the operation
to be performed, age of the patient (child or an
adult) & the personality of an adult patient.
Some guidelines for pre-operative nursing care as
follows:
1. WRITTEN CONSENT:
A surgeon has already told the patient or parents
of the child about the operation & reason for it &
risk involved in it. A written consent should be
taken.

4. For local anaesthesia:
The patient should told that he will be
awake during the procedure but feel no pain
& he/she should hold head still during
surgery.
For general anaesthesia:
To omit food & fluid by mouth since the
night.

5. 2. Jewelry:
 Remove all the jewelry and other accessories especially
females if general anesthesia is required.
3. O.T dress:
 Provide hospital dress before surgery.
4. I V Line:
 Maintain intra venous line for pre-operative
medication if ordered by Dr.
5. Check record:
 Check investigation and all the patient's record care
fully.

6. 6. Antibiotic drops:
 Instilling antibiotic drops 4 times a day for 1 or 2 days;
 Intensively, every 15 minutes for 2 Hours immediately
prior to surgery to prevent postoperative infections.
7. Re-assurance:
 Calm the patient before surgery in order to prevent
confusion of the patient during surgery.
8. Mydriatics drops:
 Instilling mydriatics drops prior to cataract extraction
or retinal detachment surgery. These drops are usually
administrated intensively e.g. every 15 minutes for
1Hour immediately before surgery.

7. 9. Anaesthetics:
 Instilling local anesthetic drops is the operation is to
be performed under a local anesthesia.

8. POST OPERATIVE
NURSING CARE

9. 1. Immediate care after G/A:
 Care of vital signs.
 Temperature (Warm the patient if
hypothermic).
 Pulse.
 Respiration ( care for secretions & give oxygen
if cyanosis).
 Blood pressure.
 I/V fluid maintainenance.
 NPO for six hours.
 Injectable analgesics, anti emetics &
antibiotics.
 Care for dressing.

10. 2. Immediate care after L/A:
 Keep the head still.
 Avoid coughing, sneezing or moving
suddenly.
 Patient should lie with the un-operated
side down to prevent pressure on the
operated eye & to prevent contamination
of the dressing with vomitus, in case
vomiting occur.
 NPO for about ½-1 hour.
 Oral analgesics may be given.

11. 3. Bed rest & ambulation:
 Patient should lie flat in bed for ten days
with his head immobilize.
 Infact the cataract operation
(phacoemulsification) has become now a
day-care surgery.
 With early ambulation the complications
associated with recumbent position in
elderly have been reduced markedly.

12.  Bed rest in specific position may be ordered
in some complicated cases of retinal
detachment surgery.
 If patient has to remain on prolonged bed
rest it should ensure that the patient
continues frequently perform exercises to
prevent complications of prolonged
inactivity.
 Frequent deep breathing sessions.

13. 4. Post operative medication:
as ordered by the ophthalmologist, a nurse
should observe sterile techniques.
5. Diet & feeding:
 a soft diet within an hour of operation after
local anaesthesia.
 Those who receive general anaesthesia are
first placed on i/v fluid, then on liquid diet
progressing gradually to a regular diet.

14. 6. Routine activities:
activities which increase intra ocular pressure are contra
indicated after intra ocular surgery. These includes:
 Excessive energy exercise.
 Crying.
 Extreme emotions.
 Sudden movements.
 Sneezing.
 Coughing.
 Running.
 Jumping.
 lifting. Or pushing heavy objects.
 Rubbing the eyes.

15. 7. Instructions at discharge & follow up:
Instructions for home going regimen are
prescribed by the surgeon. However, the
nurse has a responsibility to ascertain the
patient’s understanding of the physician’s
orders. Prior to discharge, she should make
emphasis on following points:
 Medication:
patient should familiar with home care
procedures e.g. instillation of eye drops.

16.  Eye shield:
Please use eye shield for protection when you
sleep. You may use dark glasses during daytime.
Please wash the eye shield and glasses with soap
and water each day and dry the same before use.
 Washing the face:
Cleaning of the operated eye will be as per the
instructions given by the doctor/ nurse. The rest of
the face can be mopped with a clean and wet cloth.
Avoid splashing water into the operated eye.

17.  Shaving:
Shaving is permitted. But avoid splashing
water after shaving. Instead, clean with a wet
cloth.
 Bathing:
You can bathe below neck from the first
postoperative day itself. But avoid head bath
for a period of 3-4 weeks.

18.  Use of facial cosmetics:
Avoid cosmetics to the eye such as mascara,
eye liners etc for at least 4 weeks.
 Physical activity:
Activities such as walking, talking, TV
viewing can be resumed immediately after
surgery. However, Jogging, swimming,
gardening, contact sports, etc may have to
be avoided until 4-6 weeks after surgery.

19.  Driving:
Avoid driving till your surgeon gives you
permission.
 Joining back duties:
Usually you will be allowed to join your
duties by 4-6 weeks after surgery depending
upon the surgery. You may have to check
with your doctor regards to the exact date of
joining duty.

20.  The following symptoms may be expected
after most surgeries:
Some amount of redness, watering, foreign
body sensation, and glare are common. The
severity varies with the type of surgery.
These symptoms will reduce with time and
usually disappear by 4-6 weeks.

21.  If you have any worsening of the symptoms
and specifically if there is increasing
redness, pain or decreased vision please
report as emergency to THE DOCTOR.