Reprocessing techs at outpatient ophthalmic facilities don’t often deal with grossly contaminated instruments, so it helps to alert them when tools are in need of extra attention before sterilization. “Enzymatic detergents aren’t typically used on ophthalmic instruments, but when we perform cases such as pterygium excisions or some corneal procedures, the instruments need a deep clean,” says Karen Dargan, BSN, RN, CNOR, an infection control nurse at Eye 35 ASC in Schertz, Texas. The center’s nurses include a simple handwritten note card that says “Use Enzymatic” in trays of soiled instruments if the set needs to be treated with an enzymatic solution. (Smiley faces are optional.) The grossly contaminated set is decontaminated and sterilized at the very end of the day so more attention can be given to it. That also ensures the instruments requiring enzymatic cleaning are kept separate from other sets. After decontamination is completed, the note card is discarded.