(2) Neither the clipping of eyelashes nor shaving of eyebrows is done
routinely. When eyelashes are clipped, this is done prior to the skin preparation. A thin
film of petrolatum is smoothed over the cutting surfaces of the curved eyelash scissors
so that free lashes will adhere to the blades. This prevents the free eyelashes from
falling into the eyes or onto the face.
(3) The preparation includes cleansing the eyelids of both eyes, lid margins,
lashes, eyebrows, and surrounding skin with an antibacterial soap or disinfectant. To
prevent the agent from entering the patient's ears, they may be temporarily plugged,
using cotton pledgets. Care is taken to keep the agent out of the eyes. The preparation
area is washed with warm sterile water, using soft-texture gauze or cotton sponges.
The operative area is painted with an aqueous nonirritating skin antiseptic.
(4) When toxic chemicals or small particles of foreign matter must be
removed, the eyes may be irrigated with tepid sterile normal saline solution. The
conjunctival sac is thoroughly flushed, using an irrigating bulb or an Asepto syringe.
d. Draping the Patient. For general eye surgery, the basic draping procedure
is as follows:
A large, folded sheet is needed to cover the patient and operating table.
(2) The head is draped with a double-thickness half sheet and two towels or
appropriate disposable drapes.
(3) A fenestrated eye sheet, 14 inches square, with a center opening of
2 1/2 x 3 inches, is placed over the operative site. More recently, disposable plastic
drapes have been used.
e. Anesthesia. Local anesthesia is frequently preferred and indicated for eye
surgery, especially in elderly individuals and in those with circulatory and other
systematic diseases. A sedative is given the night before surgery and again two hours
prior to surgery.
(1) Anesthesia setup. The operating room staff assembles the sterile local
anesthesia setup as ordered by the surgeon before the patient enters the operating
room and checks the bottles of drugs to make sure they are the correct medications and
of the proper strength.
Needles and syringes.
(a) Subcutaneous injection and infiltration. Two Luer-Lok 2-ml
syringes and two 25-gauge needles, 1/2-inch length may be used.
(b) Subconjunctival injection. Two Luer-Lok 2-ml syringes and two 26-
or 27-gauge needles, 1-or 1 1/2-inch length.