Assessment of eye drop instillation techniques among patients with primary open angle glaucoma in a Nigerian tertiary hospital

Purpose: To assess the technique of eye drop instillation and its determinants among patients with primary open angle glaucoma (POAG) attending a Nigerian tertiary hospital.

Methods: This study was a cross-sectional observational study conducted among 130 participants. Systematic sampling technique was used. Inclusion criteria were the presence of POAG, in individuals ≥ 18 years, and self-instilling their ocular hypotensive medications for at least 6 months. Demographic data and clinical characteristics were obtained using an interviewer-administered questionnaire and clinical examination. All participants underwent eye drop instillation of sterile water. Administration techniques were observed and graded using a comprehensive grading scheme. Patients with poor techniques were educated. Determinants of poor eye drop administration technique were also explored.

Results: One hundred and thirty patients with POAG were studied. The mean age was 57.13 ± 13.20 years, and 63% percent of the participants had poor eye drop administration technique. On multivariate analysis, previous eye drop instillation education significantly influenced eye drop instillation technique (p = 0.02; OR = 3.230; 95% CI = 1.173-8.896). Among the participants, 47 (36%) touched the globe, 128 (98.5%) did not wash their hands, and 126 (97%) did not occlude the punctum. Sequel to the training, mean score of subjects improved from 2.8 ± 1.1 to 4.1 ± 1.3 (p value < 0.001).

Conclusion: This study demonstrated that a high proportion of POAG patients had poor eye drop instillation technique despite long-term self-use of topical medication. Thus, this aspect of therapy deserves periodic scrutiny by the clinician.