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A. L. Hennessy, J. Katz, D. Covert, C. Protzko, A. L. Robin; A Video Study Evaluating Eye Drop Instillation in Subjects With Low Vision With Either Glaucoma or Retina Disease-Based Visual Impairment. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6016.
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Evaluate and compare self-administration of eye drops in both visually impaired glaucoma and retina disease subjects. No prior studies have objectively analyzed and compared eye drop instillation in visually impaired patients with glaucoma or retina disease.
Subjects completed a questionnaire on their drop use and were video-recorded instilling an artificial tear drop using a standardized 5-mL bottle onto their worse eye, with their dominant hand.
A total of 409 subjects (205 Glaucoma, 204 Retina) were included in the study. Differences between the two groups were as follows: Glaucoma subjects had fewer females (p=0.05), were younger (p<0.005), had fewer Caucasians (p<0.005), had less previous exposure to eye drop use (p<0.005), worse visual acuity (p<0.005) and less self-reported history of arthritis (p<0.05). Glaucoma subjects had more bilateral impairment (60% vs 42%, p<0.0005). Retina subjects instilled more drops onto the eye (1.7 vs 1.4, p=0.02) and more commonly contaminated the bottle (47% vs 33%, p=0.003). About one-third of each group could not get a drop onto the ocular surface with multiple attempts at instillation (30% Retina vs 29% Glaucoma, p=0.91). Among subjects placing only one drop, onto the eye, without touching the adnexae, there was a trend for glaucoma patients to perform slightly better, although both groups did poorly ("success"=39% Glaucoma vs 31% Retina, p=0.09).
Among visually impaired subjects, eye drop self-administration was a significant problem, regardless of the etiology. Though baseline differences existed, both groups performed relatively poorly. Both groups had poor perception of their ability to instill eye drops, wasted drops, and contaminated bottle tips. This has implications for "unintentional" non-compliance in chronic glaucoma therapy, and may have implications for future therapeutic delivery systems.
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