I had a bit of an ah-ha moment about many of my patients in the middle of the night. My eyes were dry last night so I put in some artificial tear drops before going to bed and kept the bottle by my bedside. At one point during the night I awoke; with eyes feeling dry, I reached for the drops, lined them up, and proceeded to put one drop on each eyelid before getting each one in my eye. It's no wonder that some of my patients go through their glaucoma drops in just 2 or 3 weeks instead of the full 6 weeks that they should last. (At least these patients are taking their drops!)
How do my patients with limited vision get any of their drops into their eyes? I was aware of some of the other issues. Many patients are on more than one glaucoma medication, some of which are once every morning, others twice daily, and still others at bedtime. At least with these it is usually possible to pick drops that have bottle with different shapes to them. That is provided they receive the brand name drugs and not the genetics that are all in similarly shaped bottles. Also, if any patient is also on an artificial tear drop or steroid or dilating drop, then they're in trouble as these all have the same shape.
We need better ways to help patients get their eyedrops in their eyes when they have limited vision. There used to be an eyecup that screws onto the top of the bottle made by Merck and Pfizer used to make the Xal-ease that only fit their Xalatan bottle. Both of these could be rested over the eye to properly position the bottle. I'm not sure if these are still available. Also, if there are better ways to help patients identify the bottles that people know about I would be interested in knowing them.