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Open Angle Glaucoma: Treatment01:27

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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Factors Associated with Topical Medication Instillation Failure in Glaucoma: VRAMS-QPiG Study.

Masaki Tanito1, Mihoko Mochiji2, Aika Tsutsui2

  • 1Department of Ophthalmology, Shimane University Faculty of Medicine, 89-1 Enya, Izumo, Shimane, Japan. mtanito@med.shimane-u.ac.jp.

Advances in Therapy
|September 14, 2023
PubMed
Summary

Glaucoma patients often fail at eyedrop instillation, with older age and lower cognitive function being key factors. Physicians should screen for these risks instead of relying on patient self-reports for successful glaucoma medication management.

Keywords:
Eyedrop instillation skillGlaucoma medicationHyperopiaImpaired cognitive functionMedication adherenceVisual field

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Area of Science:

  • Ophthalmology
  • Geriatrics
  • Clinical Pharmacy

Background:

  • Glaucoma management relies heavily on effective eyedrop instillation.
  • Patient self-assessment of eyedrop technique accuracy is often unreliable.

Purpose of the Study:

  • To evaluate eyedrop instillation techniques in glaucoma patients.
  • To identify factors contributing to eyedrop instillation failure.
  • To compare patient self-assessment with objective video assessment.

Main Methods:

  • A cross-sectional observational study involving 60 glaucoma patients.
  • Video recording of typical eyedrop instillation technique.
  • Assessment of cognitive function using the Mini-Cog test.
  • Comparison of patient-reported success/failure with examiner-based video assessment.

Main Results:

  • A significant discrepancy exists between self-reported and video-assessed eyedrop instillation success rates (57% inconsistency).
  • Over half (54%) of observed instillations failed based on video assessment.
  • Factors associated with failure included older age, lower cognitive function, less myopic refractive error, and reduced visual field sensitivity.

Conclusions:

  • Older age, decreased cognitive function, hyperopia, and reduced foveal sensitivity are significant risk factors for failed eyedrop instillation in glaucoma patients.
  • Physicians should proactively screen for these risk factors to identify patients needing assistance with medication instillation.
  • Objective assessment methods are crucial for accurate evaluation of eyedrop instillation success.