Artificial Eye, Care of (Prostheses) 

Purpose: 

• To cleanse the eye prosthesis. 

• To cleanse the eye socket by irrigation. 

• To prevent irritation and infection of the eye socket. 

Equipment: 

• Sterile irrigation syringe (or irrigation set). 

• Kidney basin. 

• Solution as prescribed (or normal saline). 

• Towel and tissues. 

• Plastic protector. 

• Cup with solution to receive prosthesis eye. 

• 4 x 4 gauze pads. 

Procedure: 

1. Preparation: 

• Place the resident in a comfortable sitting position. If the resident is unable to sit upright, position them in a side-lying position. 

• Warm the solution to body temperature (do not use a microwave). 

• Ensure all equipment is gathered and ready for use. 

2. Removing the Prosthesis: 

• Residents accustomed to caring for their own prosthesis may use their own technique. 

• Gently pull down the lower lid and apply slight pressure along the lower lid with the index finger to break the suction. 

• Carefully receive the prosthesis on a gauze pad and place it into a cup containing the warmed solution. Be cautious not to scratch the eye prosthesis. 

3. Cleansing the Prosthesis: 

• Place the prosthesis in the warm solution and keep it moist. 

4. Irrigating the Eye Socket (if ordered): 

• Place a plastic protector across the resident and/or cover them with a towel. 

• Turn the resident’s head to the side to be irrigated and position the kidney basin to collect the return flow of the irrigant. 

• Separate the eyelids with the thumb and index finger. 

• Direct the fluid flow gently from the inner to the outer canthus, allowing the solution to flow over the eye socket. Do not use pressure. 

• Continue to irrigate until the return flow is clear. 

• Observe the socket for any signs of irritation and inspect the eye prosthesis for rough areas. 

5. Drying and Replacing the Prosthesis: 

• Dry the eyelids with gauze pads. 

• To replace the prosthesis, pull down the lower lid and gently slip the lower edge of the eye into the socket. 

• Draw the upper lid over the upper edge of the prosthesis carefully to avoid damage to both the eye and the socket. 

6. Post-Care: 

• Daily cleansing may not be necessary; follow the physician's orders for the frequency of cleaning. 

7. Monitoring and Documentation: 

• Document the procedure, including any observations of the socket, the condition of the prosthesis, and any signs of irritation or infection. 

• Note the resident’s response to the procedure. 

Compliance and Documentation: 

• Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

• Ensure that all procedures are documented accurately in the resident’s care plan. 

• Regularly review and update the care techniques for artificial eyes according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on the correct procedures for the care of artificial eyes to ensure resident safety and comfort. 

• Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

• Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

• CMS Requirements of Participation for Nursing Homes.