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Table 7–2 lists commonly used ophthalmic drugs and their indications and costs.
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INSTILLING EYE MEDICATIONS
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The patient is placed in a chair with head tilted back, both eyes open, and looking up. With clean hands, the lower lid is retracted slightly, and 1–2 drops of liquid are instilled into the lower cul-de-sac. The patient then closes the eye. Gentle digital pressure, "punctal occlusion," can be applied between the nose and the medial canthus for 1–3 minutes to close off the nasolacrimal duct and allow for maximum penetration of the eyedrop onto the ocular surface. Ointments are instilled in the same general manner. Punctal occlusion is not required for ointments.
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Most eye bandages should be applied firmly enough to hold the closed eyelid securely against the cornea. One or more standard gauze-covered cotton patches is usually sufficient. Tape is applied diagonally from the forehead to the cheek.
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Eyelid taping, such as for corneal protection in facial palsy, is best achieved with 1-inch-width transparent plastic adhesive tape (eg, Transpore or even Sellotape) placed horizontally over the closed eyelids from the side of the nose to the temple. Most patients who need eyelid taping should be evaluated by an ophthalmologist.