How to Insert and Remove an Eye Medication Disk

Small and flexible, an oval eye medication disk consists of three layers: two soft outer layers and a middle layer that contains the medication. Floating between the eyelids and the sclera, the disk stays in the eye while the patient sleeps and even during swimming and athletic activities. The disk frees the patient from having to remember to instill his eyedrops. When the disk is in place, ocular fluid moistens it, releasing the medication. Eye moisture or contact lenses don't adversely affect the disk. The disk can release medication for up to 1 week before needing replacement. Pilocarpine, for example, can be administered this way to treat glaucoma.

Contraindications include conjunctivitis, keratitis, retinal detachment, and any condition in which constriction of the pupil should be avoided.

To insert an eye medication disk

Arrange to insert the disk before the patient goes to bed. This minimizes the blurring that usually occurs immediately after disk insertion.

Wash your hands and put on gloves.

Press your fingertip against the oval disk so that it lies lengthwise across your fingertip. It should stick to your finger. Lift the disk out of its packet.

Gently pull the patient's lower eyelid away from the eye and place the disk in the conjunctival sac. It should lie horizontally, not vertically. The disk will adhere to the eye naturally.

Pull the lower eyelid out, up, and over the disk. Tell the patient to blink several times. If the disk is still visible, pull the lower lid out and over the disk again. Tell the patient that when the disk is in place, he can adjust its position by gently pressing his finger against his closed lid. Caution him against rubbing his eye or moving the disk across the cornea.

If the disk falls out, wash your hands, rinse the disk in cool water, and reinsert it. If the disk appears bent, replace it.

If both of the patient's eyes are being treated with medication disks, replace both disks at the same time so that both eyes receive medication at the same rate.

If the disk repeatedly slips out of position, reinsert it under the upper eyelid. To do this, gently lift and evert the upper eyelid and insert the disk in the conjunctival sac. Then gently pull the lid back into position, and tell the patient to blink several times. Again, the patient may press gently on the closed eyelid to reposition the disk. The more the patient uses the disk, the easier it should be for him to retain it. If he can't retain it, notify the physician.

If the patient will continue therapy with an eye medication disk after discharge, teach him how to insert and remove it himself. To check his mastery of these skills, have him demonstrate insertion and removal for you.

Also, teach the patient about possible adverse reactions. Foreign-body sensation in the eye, mild tearing or redness, increased mucous discharge, eyelid redness, and itchiness can occur with the use of disks. Blurred vision, stinging, swelling, and headaches can occur with pilocarpine, specifically. Mild symptoms are common but should subside within the first 6 weeks of use. Tell the patient to report persistent or severe symptoms to his physician.

To remove an eye medication disk

You can remove an eye medication disk with one or two fingers. To use one finger, put on gloves and evert the lower eyelid to expose the disk. Then use the forefinger of your other hand to slide the disk onto the lid and out of the patient's eye. To use two fingers, evert the lower lid with one hand to expose the disk. Then pinch the disk with the thumb and forefinger of your other hand and remove it from the eye.

If the disk is located in the upper eyelid, apply long circular strokes to the patient's closed eyelid with your finger until you can see the disk in the corner of the patient's eye. When the disk is visible, you can place your finger directly on the disk and move it to the lower sclera. Then remove it as you would a disk located in the lower lid.