The Ophthalmic Office Procedures Handbook

SECTION 3 Lids, Lashes, and Adnexa

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FIGURE 7-4 Preoperative supplies: Presented are the items needed for local injection and for cleaning the biopsy area. Topical anes thetic eye drops, povidone–iodine swab sticks, 1% lidocaine with 1:100,000 epinephrine, a 30-gauge needle, and a 3-mL syringe shown here. For most office-based lid biopsies, only 1 to 2 mL of local anesthetic is required.

Prior to the procedure, the local anesthetic is drawn up into the 3-mL syringe with a large bore needle or from the sterile cap on the bottle. If the 30-gauge needle is used to draw the lo cal anesthetic, the tip will dull and be harder to go through the patient’s skin on injection. The top of the bottle should be wiped with an alcohol pad first. The mayo tray or workspace needs to be prepared with a sterile sheet covering below and the instruments placed out using a sterile

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FIGURE 7-5 Procedure supplies and instruments: Supplies shown in clude sterile 4 × 4 gauze pads, sterile cotton-tipped applicators, small chalazion clamp, 5-0 fast absorbing gut suture, needle driver, forceps, scissors, and disposable No. 15 surgical scalpel placed on a sterile field. Also seen in the left lower corner is a disposable battery-operated handheld cautery. Most lid biopsies in the office do not need a suture, a needle driver, a chalazion clamp, or a surgical blade and handle.