During a quality review focused on the care of refillable portable eyewashes (RPEs), concerns arose over performance and care. Inspections of RPEs identified deficiencies in flow, including inadequate stream height and flow rate. Issues with flushing fluid quality, particularly related to the biological quality, were also found. RPE care and use can be informed by the wealth of literature associated with contact lens care as well as swimming pools and circulated water systems (cooling or heated water). A lack of technical data and manuals hampers users’ abilities to perform routine care and maintenance. In particular, there were concerns with periodic maintenance (such as cleaning, disinfection, and sanitization). In addition, the coverage of RPEs in ANSI/ISEA Z358.1 is too brief in scope and depth to provide protection for health. A number of recommendations have been made to improve Z358.1 by expanding RPE requirements. RPEs should be employed for specific applications and situations where other options are unavailable. Given the challenges of safely and reliably maintaining RPEs, alternatives to RPEs (such as single-use wash bottles and portable eyewashes that rely on sealed, sterile cartridges) are preferable. An inspection and cleaning manual was developed for RPEs. A slide set was constructed for training personnel. Both are provided as part of the supplementary data for this article.