Glaucoma and Eye Drops

Posted: 25/05/2020 | Scottish War Blinded

Scottish War Blinded Rehabilitation Officer, Audrey Johnstone, offers expert advice on glaucoma and how to effectivey administer treatment. 

Glaucoma is a group of eye diseases caused by pressure of the fluid inside the eye damaging the optic nerve.

Most types of glaucoma have no early symptoms so a regular, routine eye test is the only way to know whether you have the condition. The earlier glaucoma is picked up and treated, the more sight can be protected.

 

Glaucoma treatment

Treatment aims to lower the pressure in your eye to prevent damage to your optic nerve. It usually starts with eye drops and, for most people with glaucoma, this is all the treatment they will need. There are various kinds of eye drops used in the treatment of glaucoma. Laser treatment or surgery may also be an option if eye drops have not been successful in keeping the eye pressure stable. Unfortunately, once sight loss occurs, it cannot be reversed as there are currently no treatments that can restore the damaged nerve.

Glaucoma is usually a slow progressive condition that can ultimately result in impaired vision. It’s therefore very important that you use your eye drops as prescribed and attend all your appointments to ensure your eye pressure remains stable and to prevent further damage.

 

How should I use my eye drops?

Many people find it difficult to put eye drops in initially and it is easy to forget to do it regularly. There are various ways to apply eye drops, depending on what suits you best.

Before you begin, always make sure you wash your hands. Some drops need to be shaken, so remember to check the instructions first.

The wrist-knuckle technique:

1. Lie down or sit down and tilt your head back.

2. Make a fist with one hand and use your knuckles to pull your lower eyelid downwards. Place your other hand with the eye drop bottle onto your knuckles

3. Look up and squeeze a drop into your lower eyelid, making sure the nozzle does not touch your eye, eyelashes or eyelid.

4. Close your eyes and gently press on the inner corner of your eye for 30 – 60 seconds to ensure the drop is fully absorbed.

Alternatively, an ophthalmic nurse told us how she recommends her patients administer eye drops:

1. Lie down on your bed or couch and tilt your head back.

2. Hold the eye drop bottle horizontally in one hand and place the screw part of the bottle on the bridge of your nose, look upwards and squeeze the bottle gently, the drop should fall into the eye. If it doesn’t, it will be in the corner next to your nose and if you turn your head slightly it will run into the eye.

3. After putting the drop in your eye, close your eye and gently press on the inner corner of your eye for 30 – 60 seconds to ensure the drop is fully absorbed.

 

Top tips for applying eye drops

· If you have difficulty knowing whether a drop has gone into your eye, keep the bottle in the door of the fridge. You will then feel the coldness of the drop going into your eye. However, always check that your drops can safely be stored this way before doing this.

· If you need to administer a different drop into the same eye, wait at least five minutes or however long you have been advised to wait. If you use a drop more than once a day, try to ensure the times you put them in are evenly spaced. It’s important to get into a routine of putting your drops in so you remember and manage every day. Doing this will help stabilise your eye pressure and treatment plan.

· If you are using an eye ointment at the same time as your eye drops, always use your eye drops first and leave a five-minute gap before using the ointment.

· If you wear contact lenses, check with your eye specialist whether these should be removed before using eye drops. If you do remove your contact lenses prior to using eye drops, wait 15 minutes after using your drops before inserting your lens. Contact lens wearers should avoid using eye drops which contain preservatives. Please speak to your eye specialist about this as they may be able to prescribe preservative free eye drops.

· Never share your eye drops with anyone else. Eye drops are for individual use.

· Some eye drops may sting or irritate for a short while after putting them in. Let your eye specialist know if symptoms become worse or you experience any side effects as the drops can be changed to help alleviate any discomfort.

· Never use drops after the expiry date, this varies between drops. Single dose unit eye drops should be used only once and discarded. Unused or expired medicines can be returned to your local pharmacist.

Are you struggling to administer your eye drops?

There are several reasons why it can be tricky to put in eye drops.

If you have dexterity issues or a hand tremor it may be difficult to hold, aim or squeeze the bottle. Using an eye drop dispenser can help and there are a range of different eye drop dispensing aids available. Your eye clinic can provide one for you – your nurse will know which dispenser suits your prescribed drops and can demonstrate how to use it effectively.

If you use several different types of eye drops and find it difficult to tell the different bottles apart, it might be useful to use coloured stickers, larger labels or elastic bands around the bottles to distinguish them. Using drops in the same order each time, either by colour or bottle size, can also be helpful.

 

Getting into a routine

It is very important that you do not stop using prescribed drops as directed by your consultant, as interrupting your treatment can cause problems with your vision. It’s worth getting into a routine and sticking to it. Here are some useful tips:

1. Unless your bottle needs to be stored in the fridge, keep it beside your medication box or beside your toothbrush so you are reminded to administer your eye drops after you brush your teeth or take medication.

2. Set a daily alarm or reminder on your mobile phone or watch.

3. Make a chart with the days of the week on it and you can tick off every time you use your drops. There is a drop calendar available to download at www.glaucoma-association.com or you can phone their Helpline on 01233 648 170.

 

Keeping your drops safe on the move

You can purchase cool wallets that prevent your drops from becoming warm for up to 45 hours. There is a large wallet that holds up to four eye drop bottles or 30 single dose eye drops and a small wallet that holds a single bottle or 10 single dose eye drops. These wallets can be purchased from the International Glaucoma Association.

 

Useful contacts

If you would like some further support, please speak to one of the Scottish War Blinded rehabilitation officers.

The International Glaucoma Association (IGA) Sightline is another helpful resource. Contact them on  01233 64 81 70 or visit www.glaucoma-association.com