The process of irrigation should proceed as follows:
• Explain to the patient what will take place. This is especially important in children who are scared and would not cooperate (see Chap. 2.16).
• Use anesthetics if necessary (see above).
• Carefully separate the lids. Placement of a lid retractor is preferred, although manual separation (see Chap 1.9) is also acceptable.
• Gently rinse the cornea and the fornices using an infusion line (Fig. 3.1.1); the infusion bottle should be 30-80 cm above eye level.
• Remove all particles" with a cotton-tipped applicator or forceps.
• Proceed with the irrigation even if the injury is open globe. Closure with sutures should follow, not precede, rinsing.
• Rinse the palpebral conjunctiva and the fornices as well; the latter requires double eversion (Fig. 3.1.2).
9 ANSI-Standard Z358.1-2004.
10 Prevor GmbH, Köln, Germany.
11 These are usually calciferous.
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