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Antonio Remolina-Villarejo, Gabriel Lazcano-Gomez, Armando Castillejos-Chevez, Jesus Jimenez-Roman, Malik Kahook; Videographic Assessment of Glaucoma Drops Instillation. Invest. Ophthalmol. Vis. Sci. 2013;54(15):777.
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To educate medical personal and patients on proper instillation technique for glaucoma drops.
Patients with glaucoma, ocular hypertension or glaucoma suspects, who were using glaucoma drops for at least 6 months were included. Best corrected visual acuity of 20/100 or better was required for enrollement. All patients were asked to instill an artificial tear drop, using the same technique they used at home. Data included: number of drops instilled in each eye, number of drops reaching ocular surface, number of times the tip of the bottle touched the eye or surrounding structures. After the first attempt, patients were counseled on proper instillation techniques. After 30 minutes, we asked them to instill a drop of the same tear to ascertain changes in behaviour after the educational session. The second instillation was also videotaped with similar data recording. Pre and post eduction video were compared.
45 patients were enrolled with a mean age of 56.8±15.05 years. Seven patients (15.5%) with ocular hypertension, 9 patients (20%) with primary closure angle-glaucoma and 29 patients (64.4%) with POAG were included. At the initial instillation event, the mean number of drops squeezed out from the bottle was 1.51±0.86, mean number of drops that reached the conjuntival fornix per patient was 0.93±0.71. In 29 patients (64.44%) the tip of the bottle touched the conjunctiva or periocular tissue with a frequency of 1.73±2.15 times. Post-education mean number of drops instilled was 1.22±0.51. The mean number of drops reaching the conjuntival fornix per patient was 1.15±0.42. The tip of the bottle touched the conjunctiva or periocular tissue in 13 patients (28.88%), with a frequency of 0.51±1.03 times per patient.
At baseline, only 66% of patients instilled one drop per application as instructed. The mean number of drops instilled per patient was 1.51 with only a mean of 0.93 drops falling directly on the eye. After the educational session, the number of patients that instilled one drop on the eye increased to 82% with a mean of 1.22 drops per application and a mean of 1.15 drops falling directly on the conjuntival fornix. The educational session appears to have enhanced drop instillation success.
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