| Videotaped evaluation of eyedrop instillation in glaucoma patients with visual impairment or moderate to severe visual field loss. | |
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MedLine Citation:
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PMID: 20580092 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Amy L Hennessy; Joanne Katz; David Covert; Colleen Protzko; Alan L Robin |
Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-07-01 |
Journal Detail:
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Title: Ophthalmology Volume: 117 ISSN: 1549-4713 ISO Abbreviation: Ophthalmology Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-06 Completed Date: 2011-01-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802443 Medline TA: Ophthalmology Country: United States |
Other Details:
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Languages: eng Pagination: 2345-52 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Glaucoma Specialists, Baltimore, Maryland, USA. hennessy.amy@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Antihypertensive Agents / administration & dosage* Female Glaucoma, Open-Angle / drug therapy* Humans Intraocular Pressure / drug effects Male Ophthalmic Solutions / administration & dosage* Patient Compliance Prospective Studies Videotape Recording* Vision, Low / complications* Visual Acuity Visual Fields* Visually Impaired Persons* |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Ophthalmic Solutions |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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