Document Detail

Videotaped evaluation of eyedrop instillation in glaucoma patients with visual impairment or moderate to severe visual field loss.
MedLine Citation:
PMID:  20580092     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Objectively evaluate the ability of visually disabled glaucoma patients to successfully administer a single drop onto their eye.
DESIGN: Prospective, observational study.
PARTICIPANTS: Experienced glaucoma patients with Early Treatment of Diabetic Retinopathy Study visual acuity (VA) of ≤ 6/18 (≤ 20/60) ≥ 1 eye, or moderate or severe visual field damage in ≥ 1 eye.
METHODS: Subjects were "low vision" (20/60 ≤ VA <20/200) or "blind" (light perception <VA ≤ 20/200). They completed a survey about eyedrop use, and were video-recorded instilling 1 drop into their worst-seeing eye in their usual fashion, using a 5-ml bottle.
MAIN OUTCOME MEASURES: Successful instillation of a single drop.
RESULTS: Of 204 glaucoma subjects (55% female; 74% Caucasian; 89% primary open-angle glaucoma; mean age, 68.8 ± 13.1 years), 192/204 (94%) used drops >6 months. Subjects used a mean of 1.9 ± 1.1 bottles of intraocular pressure-lowering medications to treat their glaucoma. Seventy-six percent (155/204) of subjects had severe visual field damage, with a mean deviation of -14.5 ± 8.0. Twenty-six percent (54/204) had acuity of ≤ 20/200 in ≥ 1 eye, and subjects had a mean logarithm of minimal angle of resolution acuity of 0.8 ± 0.9. Seventy-one percent of subjects were able to get a drop onto the eye; only 39% instilled 1 drop onto the eye without touching the ocular surface, instilling a mean 1.4 ± 1.0 drops, using 1.2 ± 0.6 attempts. Of the 142 subjects who denied touching the bottle to the ocular surface, 24% did touch the bottle to the eye. Multiple factors were tested for ability to predict successful application of an eyedrop; however, only age (< 70 vs ≥ 70 years) was found to be a significant predictor for less successful instillation.
CONCLUSIONS: In this video analysis of visually impaired glaucoma patients, we evaluated the difficulty this population has instilling eyedrops, most important, the use of multiple drops per instillation, potential contamination of a chronically used bottle, and poor patient understanding of the situation. Ability to self-administer eyedrops and cost considerations of wasted drops must be thought out before institution of glaucoma therapy. Efforts to determine better methods of eyedrop administration need to be undertaken.
Amy L Hennessy; Joanne Katz; David Covert; Colleen Protzko; Alan L Robin
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-01
Journal Detail:
Title:  Ophthalmology     Volume:  117     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-06     Completed Date:  2011-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2345-52     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Glaucoma Specialists, Baltimore, Maryland, USA.
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MeSH Terms
Antihypertensive Agents / administration & dosage*
Glaucoma, Open-Angle / drug therapy*
Intraocular Pressure / drug effects
Ophthalmic Solutions / administration & dosage*
Patient Compliance
Prospective Studies
Videotape Recording*
Vision, Low / complications*
Visual Acuity
Visual Fields*
Visually Impaired Persons*
Reg. No./Substance:
0/Antihypertensive Agents; 0/Ophthalmic Solutions

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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