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Some things never change. For at least three decades researchers have been reporting that patients with glaucoma have trouble getting drops into their eyes. As early as 1980, Michael A. Kass, MD, and colleagues identified failures to take the medications correctly—sometimes referred to as “involuntary noncompliance”—as a common problem that interferes with the care of glaucoma patients.1,2
At the 2008 meeting of the American Glaucoma Society, as well as the 2009 Annual Meeting of the Academy, Alan L. Robin, MD, and Amy L. Hennessy MD, MPH, reported findings from two video-documented studies: only two-thirds of patients were able to reliably get the medicated drop to the ocular surface. And when factoring in other variables, the success rate was even lower.3
The taming of the drop. After all these years, ophthalmologists still haven’t found a way to fix the problem. No matter how many solutions have been introduced—user-friendly bottles, drops tailored to the patient’s lifestyle, changes to the bottle tip, specially designed dosing aids—patients still often miss the mark. Hands may be hobbled by arthritis or Parkinson disease or stroke; eyes blink; drops land on foreheads and cheeks. Or, at the other extreme, patients marinate their eyes, pouring in half the bottle in one sitting.
Patients know how to take a pill, Dr. Robin said. “I would never say, ‘Put the pill between your fingers, take some water, put the pill in your mouth and swallow.’ Patients know to do that. But they don’t know how to take their drops.” Dr. Robin is a clinical professor of ophthalmology at the University of Maryland in College Park. MORE: