OPHTHALMOLOGY

Gregory Eippert, MD

Q: I am newly diagnosed with glaucoma and have to start taking two different drops. What is the best way to put drops in my eyes? Does pressing on the inner part of my eye while inserting the drops help in this process?

A: Glaucoma is a chronic, progressive eye disease that often presents as elevated intraocular pressure or IOP. For many with glaucoma, the treatment regimen involves the use of one or more kinds of eye drops to lower IOP. A lower IOP can, in turn, help to prevent further optic nerve damage and vision loss.

While there is no ‘one best way’ to put in glaucoma eye drops, here are several suggestions to help with drop management and instilling the drops for maximum efficiency.

Each time, before instilling the drops, wash your hands with soap and warm water. When taking multiple drops, allow at least 5 minutes between drops so that each drop can be well-absorbed and not washed out by any subsequent drop(s). With multiple drops, the order in which they are used does not matter. It is important also to take your drops at the same time every day and at the intervals prescribed especially if you are using multiple drops. If you miss a dose, try to take it as soon as you remember provided that it is not within an hour of the next scheduled dose. If it is close to the next dose, do not take the missed dose, simply take the next dose and then resume the schedule the next day.

Instillation: First, tilt your head back or lie flat. With the index finger of one hand, gently pull down on the lower eyelid to form a small pocket just inside the eyelid. With the other hand, hold the eye drop bottle between your thumb and index finger. Rest that hand on the hand that is gently pulling down on your lower eyelid. Try not to allow the tip of the bottle to come in contact with your hands or eyes because this may contaminate the eye dropper and raise your risk of infection.

Gently squeeze the bottle so that only one drop falls into the pocket created just inside your lower eyelid. Close your eye for several minutes being careful not to blink or squeeze your eyelids. Pressing gently against the inner corner of your eyelids right by your nose, known as punctal occlusion, helps to block off the tear drainage system so that the medicine doesn’t drain away from the eye. By keeping the eye drop in longer, there is more time for it to be absorbed for maximum effectiveness. You may experience a stinging sensation when instilling glaucoma drops, but this discomfort should last only a few seconds. When finished instilling the drops in both eyes, replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.

It is important to take your glaucoma medications regularly and precisely as prescribed. Since eye drops are absorbed into the bloodstream, be sure to tell your eye doctor about all the medications you are currently taking. Also check with your doctor or pharmacist about possible drug interactions between your glaucoma drops and any other medications you might be taking, now or in the future.