Ocular Hygiene

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Ocular Hygiene prior to and after eye/eyelid surgery(Cataract, LASIK, Eyelid Surgery, Retinal Surgery/Injections)

From an anatomic standpoint, the inside structures of our eyes are naturally protected from bacteria from the outside world. The Cornea and the Sclera are contiguous structures that shield the eye from getting infected, and the only time bacteria can enter the eye is when this continuity is disrupted. This can occur by trauma (“ruptured globe”), during surgery (e.g., Cataract, LASIK, Glaucoma), or if the eye is being injected (as is done on thousands of people everyday to treat Macular Degeneration).

It is well understood that the bacteria that can enter the eyes almost always comes from our eyelids and lashes. Universally, humans have a natural “flora” of bacteria that reside on our lashes and lids, and once open, these bacteria can easily penetrate the globe and cause devastating eye infections (“endophthalmitis”) that can lead to permanent blindness.

This is why eye surgeons across the globe ALWAYS “prep” the eyelids and eyelashes prior to any surgical procedure (injections, LASIK, cataract surgery, etc.). On a young, healthy eye, ocular hygiene prior to surgery (e.g., LASIK) is usually achieved using Betadine scrubs and topical antibiotics, but in an elderly patient with poor eyelid hygiene (with oily meibomian glands & crusty eyelashes), it is highly recommended that their eyelids are first treated with a regimen of warm compress and baby shampoo scrubs until their eyelids are thoroughly cleansed and healthy again. In fact, it is actually contra-indicated to perform any surgery on the eye in the face of “Blepharitis” as the risks of endophthalmitis go up exponentially with this condition.

Until now, this exercise has consisted of using hot towels, boiled eggs/potatoes, teabags, and microwave-heated gel masks (all of which are inconvenient and can burn the eye), followed by scrubbing the eyelashes with cotton-tipped applicators dipped in dilute baby shampoo (which is also very inconvenient and technically difficult to do especially for the elderly population who need it the most). Eye-press addresses the challenge behind achieving great eyelid hygiene prior to surgery, and by making this exercise convenient and safe, it increases compliance and improves outcomes.

The following reputable links all present detailed information and literature about the importance of eyelid hygiene prior to eye surgery and guidance regarding how to best achieve eyelid hygiene with warm compresses:

Eyeworld Article

Endophthalmitis Article

Ocular Surgery News

Improve Your Vision

Retinal Physician

All About Vision

The Merck Manual

The National Library of Medicine at the National Instutues of Health

National Eye Institute

The American Optometric Association

E-medicine Health

WebMD

All About Vision

Emedicine health

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