Glaucoma is a common eye disease unfortunately and it seems to be affecting all age groups. A recent initiative by the Ministry of Health through the Barbados Drug Service now allows anyone diagnosed with glaucoma the ability to have their eye drop prescription filled at the pharmacy of their choice at a fraction of what they would have paid before.
Glaucoma occurs when the pressure within the eyeball is high enough to cause damage to the eye sight due to damage of the optic nerve. The optic nerve is that nerve that allows our brains to interpret the electrical signals created by our retinas’ into images.
I thought it would be useful to devote an article to the best or proper use of eye drops.
1. The most important thing when using eye drops, apart from putting in the right eye drop at the prescribed time, is allowing the drop to remain in contact with the eye ball long enough to be effective.
To achieve this you can simply close your eye or eyes for one minute as soon as you put in the drops. This allows the drop to penetrate the eye, without going into the nasal duct and draining into the throat. Another trick would be to pinch gently on the area between the top of the nose and corner of the eye
2. One drop is usually enough for the eye and eye drop manufacturers have designed the dropper to be able to give consistent levels of drug in each drop. If the drop has to be shaken before use, please do so, as forgetting to shake the bottle (not yourself) will cause irregular drop sizes and may cause incomplete dosing.
3. Sixteen drops are equal to one ml of fluid. Therefore when you receive your dropper, multiplying the ml size by 16 will tell you how many days your drops can last. So 5ml dropper should give you 5 x 16 = 80 drops
4. When putting in your drops according to a schedule, remember to try to put them in at the same time every day. Twice daily means every 12 hours. Three times daily means every eight hours.
5. Sometimes patients ask if putting in too many drops accidently can be considered an overdose to the eye. As mentioned earlier, the eye can only hold one drop, and because the rest is drained away through the nose, it would almost be impossible to overdose the eye. However, the amount to reaches your throat through your nose may
cause systemic side effects. It is important that you take your time when instilling drops, as spillage can also cause a rash on the eyelids and the cheeks. Always wipe off excess drops with a dry tissue. Another issue would be that the Barbados Drug Service will only issue you with a bottle of medicine per month.
6. Sometime you may be prescribed more than one eye drop to treat your glaucoma. Do not try to put them in all at once. Put in the drops as directed and at the section of the day prescribed that is either morning or night. Going back to point 1. Put in the first drop, then close the eye or eyes for that minute, wait five minutes, then repeat that step for every eye drop prescribed.
7. First time users of chronic eye drop medicines may wonder whether they have indeed placed the drop into the eye. A feeling of wetness is one clue. Also, depending on whether it to be kept refrigerated, the cold sensation felt would suggest that the drop has met its’ mark.
8. Never allow the dropper bottle to touch the eye; this can cause the drops to become contaminated. Wash your hands before you start. Place the bottle cap in a clean place and replace as soon as you have completed the drop process. Apart from not touching the eye, do not allow the tip of the dropper to touch eye lashes or even finger tips, if possible. If you can’t avoid this from happening wipe off the tip with a dry tissue.
9. Putting your eye drops in your fridge can help to reduce stinging.
10. Always gently shake suspension eye drops. It will say suspension on the box, but if in doubt shake them anyway. This helps to evenly distribute the medicine in the drop and to disperse the preservatives through the mixture.
11. If you have difficulty putting drops or you are giving your child eye drops, lie down, close your eye and ask someone to place the drop in the corner of the eye closest to the nose, then open your eyes and the drop will roll right on to the eye. Obviously this method can be done for children or the elderly.
12. If you are using eye ointments, follow the same hygienic precautions as mentioned earlier. When instilling ointments, you can gently pull down the lower lid and squeeze a small amount into that red area between the lid and the eye. Close the eye and gently rub the lower lid.
13. It is normal to have blurred vision immediately after using ointments or even some drops. If you work nights let your eye doctor know, as most ointments are prescribed for night use, so your doctor may ask you to use the ointment during the day, when you should be resting.
14. Eye drop containers give a clue as to what the drops are used for
Our next article will be on how the glaucoma drops work.