The Morgan Lens has been used on children as young as six months of age. Pediatricians have often reported that the child often will fall asleep once irrigation is started and the irrigating solution begins to soothe the injured eye. Even adults find it difficult to fight the body’s natural reflex action and they try to squeeze the injured eye shut. This is far more difficult for a young child who is not able to understand why someone is forcefully holding the eye open. Unlike all other methods of eye irrigation, the Morgan Lens does not require the cooperation and assistance of the patient, making it ideal for use with infants and children.
Eye Development:
The eyes grow relatively little throughout life. For example, the horizontal diameter of the cornea is approximately 10.0 mm in a newborn and 11.8 mm in an adult, and the dimensions of the orbit increase from 30 by 32 mm in an 18-month-old child to 33 by 39 mm in an adult. The length of the palpebral fissure (the horizontal opening between the eyelids) increases only a few millimeters, going from about 24-25 mm in an infant to 28-30 mm by adulthood.
Since the Morgan Lens is just 23 mm in length, it can easily be slipped through the palpebral fissure into the much larger opening under the eyelids. If necessary, the lens may be rotated slightly during insertion.
Suggestions for using the Morgan Lens on infants and children:
Have a parent hold the child during the irrigation process
Reassure the child (and/or parent) that insertion of the lens will quickly alleviate pain
Use wording like “this may feel cold” or “this will be wet” rather than saying something that may cause further anxiety
Remind everyone that the Morgan Lens does not touch the eye but floats on the irrigating solution
Use lactated Ringer’s Solution (Hartmann’s solution) instead of Normal Saline
During insertion, the lens may be rotated slightly to fit more easily into the smaller opening
Studies show warmed irrigating solutions may be more comfortable for some patients
Use of an ocular anesthetic may help relieve anxiety–additional drops may be added without removing the lens (pinch the tubing and instill drops in the cul-de-sac)
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Thanks for the opportunity to sing the praises of the Morgan Lens! Those of us who have been in the field for a while wonder what we ever did without them! We find two general uses for the lenses. One is for contact irritation: most typically, splashes. After local anesthetic, for ease of insertion, the lenses fit comfortably on patients of all ages and provide gentle and thorough irrigation of irritant substances. We have many cases of this type. The second most common use is for patients show suffer multiple injuries due to automobile accidents, major trauma, burns, falls, etc. Not only does the lens thoroughly irrigate the eye, removing most or all of the debris that has accumulated, it more importantly frees up the nurse's hands so that she can perform other lifesaving functions. Quite frankly, eye irrigation was treated as "the bottom of the list" often because other patient's other injuries were more devastating with higher morbidity and mortality. Particularly in the burn patient, the soothing effect of the irrigation and potential to prevent infection or further injury, make it an easy to use, valuable asset for patient care.
Registered Nurse (Montana)
The Morgan Lens is used in 90% of hospital emergency departments in the USA and can be inserted in less than 20 seconds. There simply is no other "hands-free" method of eye irrigation. Nothing else frees medical personnel to treat other injuries or to transport the patient while irrigation is underway. Nothing is more effective at treating ocular chemical, thermal, and actinic burns or removing non-embedded foreign bodies, even when the patient's eyes are closed tightly. Its design makes it simple and straightforward to use so minimal training is required.