For people with glaucoma, instilling medicated eye drops properly is vital for successful disease management. Ophthalmologist Yvonne Ou, M.D. of the University of California, San Francisco Medical Center offers practical tips to help patients become better skilled at this daily task.*

Avoid Contamination

Before applying eye drops, there are several ways to make sure the medication doesn’t get contaminated:

• Wash your hands thoroughly
• Avoid letting the dropper tip touch any part of your eye or fingers
• Place the bottle cap on a clean surface
• Never leave the bottle open when not in use

If you do accidentally touch the bottle tip, clean it with a fresh tissue or rubbing alcohol pad. 

Drop It in the ‘Pocket’

To properly install eye drops, tilt your head (if you don’t have neck issues) and stand before a mirror, if necessary.

• Use the index finger of your non-dominant hand to form a “pocket” with the lower eyelid, by gently pulling it down.
• Holding the bottle between the thumb and first two fingers of your dominant hand, squeeze one drop into the pocket without excessive blinking.
• Keep your eye closed for two minutes to let the drop sink in.

If you’re shaky, you can use both hands while still forming the pocket with the non-dominant hand. If you have neck issues, you can lie flat during installation.

Keep the Eye Closed

Ou reassures patients that one drop is “more than enough for the eye to handle,” even if some runs down the face. To ease concern, she recommends refrigerating eye drops so you can feel it being applied.

That said, she reiterates the importance of keeping the eye closed for two minutes so the eye absorbs the medicine. Blinking triggers the eye to drain out tears.

Block the Tear Ducts

While your eye is closed, Ou recommends placing your index finger on the tear ducts, called puncta, by the inner corner of the eye, in order to block the drainage system for tears. It also keeps the drops away from your nose and throat, avoiding any harmful interactions with your body. “Therefore, the ideal way to instill your eye drops,” Ou says, “is to combine both methods: close your eyes and press on the inside corners for two minutes after a drop is instilled.”

Time Your Eye Drops

If multiple drops are needed, wait 3-5 minutes for the first drop to be absorbed so that it doesn’t wash away the second drop. Ou says the order of the drops does not matter, except for ointment, which should always be applied last.

The best time of day for eye drops taken once daily can vary. Prostaglandin analogues, like bimatoprost and latanoprost, are best taken at bedtime. For drops taken twice daily, dosing is every 12 hours. For drops taken three times daily, dosing is every 8 hours.

For multiple-dose drops, Ou says an hour plus or minus this schedule is fine. “The most important thing is to make sure you instill the drops the correct number of times each day.”

Set Reminders

With busy days and packed medication schedules, eye drops can sometimes get overlooked. To make it easier to remember, Ou recommends combining eye drops with other daily needs. For example, multiple-dose eye drops could be taken before meals or when brushing your teeth. Another “cue to action” could be setting a phone alarm or keeping a chart.

Ease the Irritation

Many glaucoma eye drops can irritate or burn the eyes. Using artificial tears before instilling the drops can help. Wait five minutes after using artificial tears before instilling the glaucoma drops. Overnight gels and ointments can also be used to help soothe the eyes. (Wait five minutes after instilling all the glaucoma drops before applying.)

Be Patient, Ask Questions

It takes time to use eye drops correctly. Ou advises practicing with artificial tears, to conserve medication. She says to speak with your pharmacist or eye doctor about any concerns and difficulties with eye drops: trouble squeezing the bottle, instillation (have your doctor review your technique), running out of drops too quickly, etc. 

Be sure to bring all eye drops to your doctor appointments to avoid any confusion.

*Ou, Y. (2021, July 6). 10 Tips for Using Glaucoma Eye Drops. BrightFocus Foundation. https://www.brightfocus.org/glaucoma/article/10-tips-using-glaucoma-eye-drops