If you or someone you love has been diagnosed with glaucoma, you’re probably aware of how critical it is to take prescribed eye drops regularly. But there’s another, often overlooked, factor at play: how exactly these eye drops are being instilled. A fascinating study published in the Journal of Glaucoma shines a light on this very issue, revealing that a surprising number of glaucoma patients are not administering their eye drops correctly.
Below, we break down the study’s key findings and explore why proper eye drop technique matters so much—for your vision, your health, and your wallet.
Study Overview
Researchers evaluated 70 patients with glaucoma, all of whom had been using anti-glaucoma eye drops for at least six months. Each patient was observed while putting drops into one eye, and the clinicians documented:
- How many seconds it took to instill the first drop
- How many drops actually landed in the eye
- Whether the bottle tip touched the eye or surrounding skin
- Whether the patient closed their eye or pressed on the tear duct (punctum) after instillation
The results were eye-opening: nearly 9 out of 10 patients were unable to instill their drops correctly.
Key Findings
Multiple Drops Dispensed On average, patients squeezed out 1.8 drops per attempt, often resulting in medication overflowing onto the cheeks. This not only wastes medication but also increases the risk of side effects when excess drug drains through the tear ducts into the bloodstream.
Misdirected Drops More than 30% of patients missed the conjunctival sac completely at least once—meaning the drops landed on their lids or cheeks. This can lower the dose actually reaching the eye and diminish the therapeutic effect.
Bottle Tip Contamination Around 75.7% of participants accidentally touched the tip of the bottle to the eye or its surroundings, risking bacterial contamination. Contaminated bottle tips can lead to infections or corneal abrasions.
Post-Instillation Technique Fewer than 6% of patients performed punctal occlusion (gently pressing the tear duct at the corner of the eye) to limit systemic absorption. Only about one-quarter closed their eyes after instillation to help the medication stay on the ocular surface longer.
Lack of Education Most patients were never formally shown how to instill drops, yet it’s a skill crucial for effective treatment.
Why Technique Matters
- Medication Effectiveness: Correct placement ensures the drug stays in contact with the eye longer, improving absorption and lowering the risk that glaucoma remains undertreated.
- Safety and Comfort: Minimizing the chance of scratching the eye with the bottle tip helps prevent irritation or infection.
- Reduced Costs: Wasted drops mean you run through bottles faster, raising the cost of treatment. Effective use can help you avoid premature refills.
- Fewer Side Effects: Lowering systemic absorption (by closing the eyelid or applying punctal pressure) can reduce unwanted effects like heart or breathing issues associated with some glaucoma medications.
Tips for Proper Eye Drop Instillation
Wash Your Hands First Before touching your face or the bottle, thoroughly wash and dry your hands.
Position Yourself Comfortably You can lie down or tilt your head back. Looking upward helps expose the conjunctival sac (the pocket between your eye and lower eyelid).
Hold the Bottle Correctly Place the tip a short distance above your eye—without touching the eyelid or lashes.
Instill a Single Drop Gently squeeze the bottle. One drop is usually enough, since the eye cannot hold much fluid at once.
Close Your Eye After the drop lands in the eye, close your eye gently for about 2–3 minutes. Do not blink rapidly, as that can expel the drop.
Consider Punctal Occlusion Lightly press the inner corner of your eye (near the nose) for 1–2 minutes. This helps reduce drainage and systemic absorption.
Avoid Tip Contact Ensure the tip does not touch any part of your eye or face to minimize contamination.
Nanodrops Editor: Consider using optimally sized eye drops using a device such as the Nanodropper or similar.
The Bottom Line
This study highlights a crucial yet often overlooked aspect of glaucoma management—proper technique in eye drop instillation. Even the most potent medications won’t help if they aren’t delivered correctly. If you struggle with instilling eye drops, or you’re unsure whether you’re doing it right, ask your ophthalmologist or optometrist for a quick demonstration. Taking the extra time to perfect your technique can make a world of difference for both your eye health and your peace of mind.
References: Gupta R, Patil B, Shah BM, Bali SJ, Mishra SK, Dada T. “Evaluating Eye Drop Instillation Technique in Glaucoma Patients.” Journal of Glaucoma. 2012;21(3):189–192. citeturn0file0