Question 72 of 100
(demo test)
Product Demo for COA Exam Questions
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You are instilling proparacaine, a numbing drop, before you check a patient's eye pressure. The tip of the bottle accidentally touches the inside of the patient's lower lid. What is the most appropriate step to take next?
The right step is to throw out this bottle. The textbook is firm on this point. The tips of open eyedrop bottles should never touch the patient. Once the tip has touched the lid, the lashes, or the eye, that bottle is contaminated. Germs from the ocular surface can now reach the fluid inside. The bottle is no longer safe for this patient or for anyone else.
The risk here is bigger than one eye. Eye drop bottles are used on many patients, so one dirty bottle can pass an infection to a whole day of visits. The textbook calls this common-vehicle transmission: microbes spread from one source to many people. It also warns that serious eye infections can follow the use of contaminated medicine. That is why drop bottles are dated when opened and replaced on a schedule, even when they are not empty. The same rule covers the cap. Do not let the inside edge of the cap touch anything except the bottle.
Build the habit before the mistake happens. Pull the lower lid down and out with your little finger, then aim the drop into the cul-de-sac, not at the cornea. If the tip does touch, stop and open a fresh bottle. Safe handling of ophthalmic medicines is a core part of the COA pharmacology content area.
Incorrect Answers
- A. Alcohol or bleach on the tip does not clean the fluid inside the bottle. The solution itself is already exposed, and those chemicals would harm the eye.
- C. Wiping moves material around. A tissue cannot remove microbes from the tip or from the medicine held behind it.
- D. An autoclave uses steam at about 250 degrees Fahrenheit for 30 minutes. It is meant for glass and stainless steel, and it would ruin both the plastic bottle and the drug.
Testing Pearls
- A dropper tip that touches a patient makes the whole bottle unusable.
- Keep the tip off the lids, lashes, and eye surface during every instillation.
- Date drop bottles when opened and replace them on schedule, even if fluid remains.
- Contaminated drops spread infection by indirect contact and common-vehicle transmission.
- Autoclaves sterilize glass and stainless steel, not medicine bottles.
References
- American Academy of Ophthalmology. Ophthalmic Medical Assisting: An Independent Study Course. Chapter 6, Basics of Ophthalmic Pharmacology.
- American Academy of Ophthalmology. Ophthalmic Medical Assisting: An Independent Study Course. Chapter 7, Microorganisms and Infection Control.
