OP3.7 | Topical Ocular Medication Instillation and Patient Counselling — Summary & Reflection

KEY TAKEAWAYS

Correct eye drop instillation technique is a patient-safety skill: the conjunctival sac holds only 7–10 μL (standard drop = 30–50 μL), so only one drop is needed and overflow is normal. Drop instillation: head back → lower lid pocket → drop into pocket (NOT on cornea) → close gently (NOT squeeze) → nasolacrimal occlusion (press medial canthus) for 1–2 minutes. NLO prevents nasolacrimal drainage and systemic absorption — critical for timolol (beta-blocker, causes bronchospasm in asthma via systemic absorption; nasolacrimal route bypasses hepatic first-pass) and topical steroids. Multiple drops in same session: wait ≥5 minutes between each; ointments go LAST (blur vision, use at bedtime). Suspensions: shake before use (prednisolone acetate). Bottles discard 28 days after opening; do NOT share. Counselling: teach-back is most effective; cover NLO, timing, storage, systemic red flags. Storage: prostaglandin analogues (latanoprost) refrigerated before opening.

REFLECT

In your clinical posting, observe how a nurse or pharmacist counsels a patient on a new eye drop prescription. How much of the technique instruction from this SDL was covered? What was omitted? Based on this observation, what do you believe is the single most frequently skipped counselling point in real practice — and what would you change about the counselling workflow if you were running the outpatient clinic? Write two sentences for your reflective portfolio.