Glaucoma medication lowers eye pressure to protect the optic nerve and preserve sight. To achieve this outcome, you and your ophthalmologist need to identify the eye drops that work best for you. Any given medication’s effectiveness can only be determined with your strict adherence to the treatment regimen. Here are some tips from the experts at Glaucoma Associates of Texas (GAT) to help you follow your doctor’s recommendations, especially as you’re getting used to your first prescription.*

The Importance of eye drop compliance

Eye drops must be used correctly to be effective or your glaucoma can worsen. There are many ways patients can get off-track when using their glaucoma eye drops. These can include:

• Forgetting or otherwise missing doses,
• Applying the drops incorrectly, 
• Washing away the drops with tears or too much blinking, and 
• Administering drops inconsistently and/or only around doctor appointments.

Applying doses of the same eye drop too close together or too far apart can reduce its effectiveness. If taken too close together, the first drop can actually be displaced by the second.

A second drop could also lead to overdose and side effects.

Why glaucoma drop compliance is often poor

Non-compliance isn’t unique to glaucoma, but it is particularly prevalent with glaucoma, with as many as half of all glaucoma patients not following their doctor’s directions. There are many reasons for this.

• Glaucoma in its most common form is mostly asymptomatic, with visual changes only after significant optic nerve damage. People often think they don’t need treatment.
• Glaucoma is chronic and treatment lifelong, with several medications typically needed for management. This can be expensive and inconvenient.
• Glaucoma treatment benefit isn’t readily apparent. A glaucoma patient often cannot tell whether treatment is working, since there is typically no change in vision. 
• Glaucoma eye drops can have side effects, such as decreased vision or increased heart rate. This can cause a person to skip doses to avoid the unpleasantness or discomfort.

How to improve compliance for best results

“Education is perhaps the most important single means for improving compliance,” states GAT. “A patient who is educated about the nature of glaucoma and its treatment is most likely to be a better patient, and correctly use their eye drops.” Their suggestions include the following.

• Know your disease. Understand that, in most cases, glaucoma has no symptoms and treatment results aren’t apparent. Glaucoma occurs when optic nerve fibers are gradually and irreversibly damaged, leading to loss of vision. Elevated eye pressure is a common cause of this damage. Eye drops typically reduce pressure for four (4) to 24 hours, so consistent use is vital, even though benefits may not be noticeable and vision may even worsen. 
• Learn the correct use of eye drops. Close your eyes gently and block your tear ducts with your fingertips for a couple of minutes after applying eye drops. This helps the eye absorb the medication. If more than one eye drop is used at the same time, wait at least five minutes between doses for maximum absorption of the first drop. GAT advises reporting any side effects to your doctor, as well as having them review your eye drop technique. 
• Simplify scheduling. A beta-blocker eye drop, for example, may be able to be taken twice daily: once each morning and once each evening, which is easier to remember. Another tactic is to schedule use around routine daily events, like waking up and going to sleep, or regularly spaced meals. 
• Form a support network. With the help of your doctor, educate family and friends on glaucoma, its treatment, and the importance of following medication instructions (for instance, teaching your spouse to assist in applying eye drops).

Listen to your doctor

“Listening to and following your eye doctor’s recommendations not only improves the likelihood of successful treatment, but allows them to determine whether the eye drops are beneficial or additional ones are needed,” GAT says. Once the best medication for you has been found, they add, “you need to use the recommended eye drops!”

*Glaucoma Associates of Texas. (n.d.). Compliance with Glaucoma Treatment. https://www.glaucomaassociates.com/glaucoma-treatments/compliance-with-glaucoma-treatment