Patients prefer once-daily glaucoma drops.

BACKGROUND: The relationship between complexity of eye drop regime and compliance is not straightforward, i.e. fewer drops may not mean better compliance. We investigated the level of inconvenience different eye drop regimes incurred in comparison with a once-daily (OD) regime for patients experienced with using topical anti-glaucoma medication. METHODS: Patients indicated the level of inconvenience from drop regimes of 1, 2, 3 or 4 times daily on 10-cm visual analogue scales. The score for the OD regime was then compared with the scores for the other regimes using paired t-tests with Bonferroni correction. RESULTS: At a significance limit of p = 0.05, five of six subgroups indicated once-a-day drops were significantly more convenient than other regimes. Patients who had used the OD regime considered this difference greater than those who had not. CONCLUSIONS: This study's results offer some pragmatic guidance on choice of therapy and on counselling patients about compliance. We would suggest starting patients on OD drops in preference to alternatives to promote compliance.

Are disposable prisms an adequate alternative to standard Goldmann tonometry prisms in glaucoma patients?

PURPOSE: To evaluate the accuracy and reliability of 2 single-use tonometry devices (Tonosafe and Tonojet) as an alternative to standard Goldmann prisms in patients attending dedicated glaucoma clinics. DESIGN: Prospective experimental study with human subjects. PARTICIPANTS: Two hundred forty glaucoma patients who attended 2 glaucoma clinics at the Stepping Hill Hospital between January and February 2005. METHODS: During each examination, intraocular pressure (IOP) was measured 3 times, using the standard Goldmann prism, Tonosafe, and Tonojet, respectively. The prism sequence was predetermined at random using a computer, and the measurements were taken at 5-minute intervals. Data were analyzed using the Bland-Altman method of differences. MAIN OUTCOME MEASURE: Intraocular pressure. RESULTS: Intraocular pressure ranged from 6 to 68 mmHg. Linear regression analysis indicated that there was a proportional bias between Goldmann and Tonosafe (r2 = 0.368, P<.001), especially for values higher than 25 mmHg. On the other hand, there was no statistically significant proportional bias between Goldmann and Tonojet (r2 = 0.006, P = 0.14). CONCLUSIONS: Caution should be exercised when using Tonosafe prisms in the presence of IOP higher than 25 mmHg. On the other hand, Tonojet is an adequate and useful alternative to the Goldman tonometer for glaucoma patients.