Systemic medication usage in glaucoma patients.

OBJECTIVE: To study the prevalence of the systemic use of some common classes of medications by glaucoma patients and their relationship to the prevalence and severity of chronic open-angle glaucoma (COAG) and primary-angle closure glaucoma (PACG). DESIGN: Observational prospective single-centre cross-sectional study. METHODS: Glaucoma patients or their pharmacist provided an updated list of all systemic medications that they presently use. The relationship between glaucoma type and severity and medication use for diseases other than glaucoma was assessed by univariate statistics. RESULTS: We studied 514 glaucoma patients. They use a mean of 4.9 oral medications prescribed by a mean of 2.1 doctors. Antihypertensives, medications with anticholinergic properties, steroids, anticoagulants, and thyroid hormones were the most frequently prescribed groups of medications, used by 251 (49%), 178 (35%), 100 (19%), 218 (42%), and 108 (21%) patients, respectively. Steroid usage was associated with advanced visual field loss in COAG patients. Antihypertensives and medications with anticholinergic properties were not associated with severity of COAG and PACG, respectively, and these 3 groups were not associated with an increased prevalence of diagnosis of COAG or PACG. CONCLUSION: Glaucoma patients take many systemic medications in addition to their topical glaucoma treatment.

Evaluation of eyedrop administration by inexperienced patients after cataract surgery.

PURPOSE: To evaluate efficacy and safety of eyedrop administration after cataract surgery and to identify predictors of better technique in patients without previous eyedrop experience. SETTING: Department of Ophthalmology, McGill University, Jewish General Hospital, Montreal, Quebec, Canada. DESIGN: Prospective cross-sectional study. METHODS: Eyedrop-naïve postoperative cataract patients were consecutively recruited the day after cataract surgery. Data were collected using a standardized self-reporting questionnaire and a chart review and by videotaping patients administering the drops in the operated eye. Two independent observers objectively evaluated the instillation technique. Predictors were assessed using odds ratios (ORs) from a logistic regression model. RESULTS: The study enrolled 54 patients. Subjectively, 17 patients (31%) reported difficulty instilling the eyedrops. Sixty-nine percent reported always washing their hands before using the drops, 42% believed that they never missed their eye when instilling drops, and 58.3% believed they never touched their eye with the bottle tip. Objectively, 50 patients (92.6%) showed an improper administration technique, including missing the eye (31.5%), instilling an incorrect amount of drops (64.0%), contaminating the bottle tip (57.4%), or failing to wash hands before drop instillation (78.0%). A better performance score was significantly associated with having received instructions on how to use drops (OR, 11.99; P=.011). CONCLUSIONS: Postoperative cataract patients inexperienced with eyedrop use showed a poor instillation technique by failing to wash hands, contaminating bottle tips, missing the eye, and using an incorrect amount of drops. There was a large discrepancy between the patients' perceptions and the observed technique of drop administration. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.