Abstract
Purpose: :
To study the method of administration of eye drops in glaucoma patients visiting a tertiary eye care facility in North India
Methods: :
In this cross-sectional observational study 53 patients with POAG or PACG with an uncorrected visual acuity of 1/60 or more in the better eye were evaluated. All patients were instructed to instill a tear substitute (0.5% sodium carboxymethyl cellulose) in one eye, using the technique they use for administration of glaucoma eye drops at home. The time required to instill the first drop (time from opening of bottle to instillation of the first drop into the eye), the number of drops squeezed out from the bottle, location of the drops landing on the face or eye, whether patient touched the dropper tip to the globe or to periocular tissue and whether patient closed eyelid or occluded the tear duct after the administration of drops were recorded by observer (RG).
Results: :
The mean age was 51.7 + 15.3 years (38 males, 15 females). Mean time taken to instill a drop was 14.96 + 4.33 seconds (range 8.78 to 23.53 seconds). The mean number of drops squeezed out from the bottle was 1.9 + 1.3 drops (range 1 to 8 drops) per patient. Actual number of drops squeezed out from the bottle per treatment were 1 drop in 25 patients (47.2%), 2 drops in 17 patients ( 32.1%), 3 drops in 6 patients (11.3%), 4 drops in 3 patients (5.7%), 6 and 8 drops in 1 patient each respectively. The mean number of drops reaching the conjunctival sac per treatment was 1.4 + 0.7 drops (range 1 to 4). In 14 patients (26.4%) the eye drops fell on the eyelids or cheek. Forty patients (75.5%) touched the dropper tip to the globe or periocular tissue. Ten patients (18.9%) closed eyelids for ≥ 3 minutes after the drop administration and 2 (3.8%) occluded the tear duct. Only 5 patients (9.4%) were able to correctly instill the eye drops (squeeze out one drop and instill it into the conjunctival sac without dropper contact).
Conclusions: :
Nine out of 10 glaucoma patients were not able to correctly instill eye drops into the eye. It is imperative that health care providers demonstrate the correct technique for instillation of eye drops when giving the initial prescription / dispensing glaucoma medication.
Keywords: drug toxicity/drug effects • learning