Originally published in the Spring 2021 edition of Insight, our quarterly membership magazine.
Eye drops… Love them or hate them, most people with glaucoma will use them at some time in their life. When used effectively, eye drops can help you self-manage your IOP (intraocular pressure) which in turn reduces the pressure on the optic nerve and helps to preserve sight.
Sounds simple enough right? Well, evidence from talking to people with glaucoma tells us that ‘simple’ is not a word that many use when talking about drops. Glaucoma eye drops can be an amazing self-management tool, but we speak regularly to people who have issues with putting them in, experience side effects, and struggle to keep on top of a sometimes complicated treatment routine.
To help us compile the best tips and hints, we spoke to a professional who lives and breathes glaucoma eye drops. Angela James is an Ophthalmic Pharmacist at the Edinburgh Eye Pavilion. Her pharmacy specialism is eye medication and drawing on her experience, she has produced the following top ten tips for glaucoma eye drops.
If using more than one eye drop at the same time, leave five minutes between each drop.
This is so you don’t wash one drop out with the another! If using more than one drop at the same time, put them in the order of ‘thinnest to thickest’. Put ointments in last – at least five minutes after the last drop.
Immediately after putting the drop in, press lightly on the inner corner of the eye for 30 seconds (punctal occlusion).
This keeps the drop in the eye and prevents it draining through the tear duct and down the back of the throat. Punctal occlusion helps to reduce the chances of side effects due to swallowing the drop and ensures maximum effectiveness.
Some eye drops are suspensions and must be shaken well before putting them in.
If not mixed well, it will be watery at the top and too concentrated at the bottom.
If you struggle to know if a drop has gone into the eye, you can store most drops in the door of the fridge. This makes the drop cooler and easier to feel when it goes in.
If the drop is a suspension (e.g. Brinzolamide, Azarga), make sure you shake well before use as cold drops may take longer to mix.
Space drops out at regular intervals.
For example, twice daily = morning & evening / night (not morning & lunchtime)
Different generic brands of the same drop may come in different bottles, so they may look different each time.
Check the name of the drop on the label and the bottle / box. If you’re not sure, don’t be afraid to check with the pharmacist!
Different generic brands of different drops may come in similar coloured boxes, so different drops may look similar.
Check the name of the drop on the label and the bottle / box and again, don’t be afraid to check with the pharmacist.
Compliance aids can help you put your drops in.
Only a couple can be prescribed by your GP. Most have to be bought but are not expensive. Some are universal and fit most standard round bottles but some are specific to certain brands. Aids are also available for single use vials (e.g. Monopost).
Glaucoma UK have lots of information on compliance aids on their website, and you can also talk to your doctor / nurse / pharmacist.
Unfortunately, there is no aid (yet) available for newer preservative-free multidose bottles (e.g., Eylamdo, Eydelto etc).
Hints for the new preservative-free multidose bottles (e.g. Eylamdo, Eydelto, etc):
Due to the design of the container, using these drops is not the same as standard eye drop bottles. The bottles have a filter to keep the drops sterile. This means the drops are slower to come out, so there may be a few seconds delay between squeezing and the drop releasing.
Once you have put the drop in, and before putting in the other eye or recapping, shake the bottle ONCE downward to remove the drop remaining on the nozzle. This gets rid of any unsterile residue and prepares the bottle for the next treatment.
Order repeat prescriptions at least one week before required to avoid running out.
If you get a prescription for Latanoprost or Tafluprost before you need them, they have to go in the fridge until you open them (then keep for four weeks at room temperature).