(d) Miotic drugs cause the pupil of the eye to contract. Commonly
used miotics are 1 percent to 4 percent pilocarpine and 0.012 percent to 0.25 percent
phospholine iodides . Miotics improve the ease with which the aqueous fluid escapes
from the eye independent of their action on the pupil, thereby resulting in decrease of
intraocular pressure. Miotics are used in the treatment of glaucoma. These drugs
increase contraction of the sphincter of the iris, thus causing it to become smaller.
Phospholine iodide is usually discontinued before intraocular surgery is performed.
(e) A great number of corticosteroid preparations exist. They are used
to prevent the normal inflammatory response to noxious stimuli. Corticosteroids reduce
the resistance of the eye to invasion by pathogens; therefore, they are not used in the
presence of infection.
(f) Topical antibiotics are often used prophylactically to prevent
infection. Antibiotic instillation may be given prior to intraocular surgery to help prevent
wound infection. Zinc sulfate, 0.25 percent, is used to reduce redness and swelling and
to soothe tissue. It may be ordered in combination with a 0.125 percent preparation of
phenylephrine. Zinc also is a necessary cofactor in wound healing. Lubricating drops
or ointments such as Methylcellulose, 0.5 percent, are often used to protect the cornea.
(g) Hyperosmotic agents increase the osmolarity of the serum and, by
the effect of the induced osmotic pressure gradient, shrink the vitreous body and reduce
the intraocular pressure. These drugs are used routinely in the preoperative medication
of patients about to undergo ophthalmic surgery, as well as therapeutically in cases of
uncontrolled glaucoma. These drugs, given either orally or by injection, induce diuresis,
so nursing personnel have urinals and sterile catheters on hand.
b. Admission into the Operating Room. When the patient is admitted to the
operating room, the nursing team should:
(1) Make positive identification of the patient by name, dealing with him in a
gentle, kind, and professional manner.
Check the patient's name on his wristlet band with the name on the
(3) Prepare the operating table, making sure all the necessary attachments
for the table are in proper readiness.
c. Preparation of the Patient's Face.
(1) Preparation of the patient is done under aseptic conditions. Topical
anesthetic drops are administered first if the patient is to be given a local anesthetic. A
sterile preparation tray containing sterile normal saline solution, irrigation bulbs, basins,
cotton, sponges, towels, and antibacterial skin disinfectant should be near the operating