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Ninita Helen Brown, Kelsey Kubelick, Sandra S Stinnett, David L Epstein, Kelly W Muir; An upright eye drop bottle. Invest. Ophthalmol. Vis. Sci. 2014;55(13):485.
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Most patients with glaucoma are prescribed eye drops to be administered daily, often multiple times per day, indefinitely. Inability to successfully administer drops leads to missed doses and missed doses are associated with greater risk of vision loss. Available eye drop bottles require the patient to recline the head and invert the bottle, tasks which are difficult for patients with arthritis or tremor. The purpose of this project is to test the feasibility of an upright bottle and to gather feedback to improve the prototype.
Adult patients with a diagnosis of medically-treated glaucoma were enrolled. Patients who provided informed consent were shown a presentation demonstrating use of the prototype bottle. Participants used the prototype and a conventional bottle separately to administer saline drops into each eye for 3 trials of each bottle. A trained observer noted if 1) a drop was successfully instilled, 2) drops rolled down the cheek indicating excess drop expression, 3) the bottle tip was contaminated, and 4) the time until drop instillation. Participants were given a survey querying satisfaction and feedback.
19 participants aged 54-89 years (mean 73 years) included 9 men, 10 women. 12 participants reported problems aiming the conventional bottle. 17 participants successfully instilled a drop with the prototype bottle on their first trial. The mean time to drop instillation improved for the prototype bottle with successive trails (trial 1: mean 53+/-38 seconds, trial 2: mean 40+/-35 seconds; p=0.02). There were no significant differences between the prototype bottle and the conventional bottle in successful instillation of drops, excess drop expression, or contamination of the tip (p=0.05-1.0). Participants reported satisfaction with the upright bottle design and suggested adding a button or lever to improve the drop expression with the prototype.
Participants with glaucoma successfully administered eye drops with a novel, upright bottle, even on initial trial in this ongoing study. Time to successful drop instillation improved with practice. Participant feedback suggests that addition of a button or lever may improve ease of use. An eye drop bottle which allows patients to administer eye drops with the head and bottle in the upright position has the potential to improve the success and comfort of daily treatment for patients with medically-managed glaucoma.
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