视力受损的青光眼与视网膜患者滴注的视频研究

Purpose:To compare self-administration of drops in both visually impaired glaucoma subjects and retina subjects. Design:Prospective, observational study. Methods:Setting: Distinct glaucoma and retina practices. Study Population: Subjects with glaucoma or retinal diseases with visual acuity of 20/60 or worse in 1 eye, significant field loss, or both. Observation Procedures: Subjects were video recorded self-instilling a drop onto the worse eye. Main Outcome Measure: Proper instillation of eye drop onto ocular surface. Results:We included 409 subjects (205 glaucoma, 204 retina). Differences between the groups included the following: glaucoma subjects included fewer females (P=.05), included fewer white persons (P<.005), had worse visual acuity (P<.005), had less self-reported arthritis (P<.05), were younger (P<.005), and had more previous exposure to drop use (P<.005). Glaucoma subjects had more bilateral impairment (60% vs 42%; P<.0005). Retina subjects instilled more drops (1.7 vs 1.4; P=.02) and more frequently touched the bottle to the eye (47% vs 33%; P=.003). Of subjects claiming not to miss the eye, nearly one third from each group (P=.32) actually missed. Approximately one third of each group could not get a drop onto the eye (30% retina vs 29% glaucoma; P=.91). Among subjects placing 1 drop onto the eye without touching the adnexae, there was a trend for glaucoma patients to perform better, although both groups did poorly (success, 39% glaucoma vs 31% retina; P=.09). Conclusions:Among visually impaired subjects, regardless of cause, drop administration was a problem. Both groups wasted drops, contaminated bottles, and had inaccurate perception of their abilities. This has implications for future therapeutic delivery systems.