Influence of container structures and content solutions on dispensing time of ophthalmic solutions

Yoshikawa, Keiji; Yamada, Hiroshi

doi:10.2147/opth.s10804

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Davis et al summarized rates of eyedrop instillation failure as follows: between 18.2 and 80% of patients contaminate their eyedrop bottle by touching their eye or face, 11.3-60.6% instill more than one drop, and 6.8-37.3% miss the eye when attempting to instill a drop [7]. Many factors are reported to be related to instillation failure: older age, insufficient instruction on the eyedrop instillation technique, female sex, arthritis, inadequate posterior bending of the head, much more severe visual-field defects, lack of positive reinforcement to take eyedrops, lower educational level, low self-efficacy, shape and hardness of eyedropper bottles, drug viscosity, and being seen at a clinic rather than a private practice [7][8][9][10][11][12]. However, previous results were not consistent.…”

Section: Introductionmentioning

confidence: 99%

Investigation of visual and physical factors associated with inadequate instillation of eyedrops among patients with glaucoma

et al. 2021

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Purpose The aim of this study was to investigate the frequency of eyedrop instillation failure and its related physical and visual function factors among glaucoma patients who used hypotensive eyedrops daily. Subjects and methods Patients with a history of self-instillation of one or more ocular hypotensive ophthalmic solutions for six or more months were enrolled. Definitions of instillation failure were eyedrop instillation other than on the eye surface; eyedrop contact with eyelashes; eyedrop bottle tip contact with the eyelashes, eye surface or ocular adnexa; or two or more drops instilled with one instillation trial. To clarify factors related to instillation failure, we used visual function tests and investigated cervical spine extension angles during instillation, pinching strength, physical ataxia (evaluated using the Scale for the Assessment and Rating of Ataxia), motor dysfunction of the upper limbs (evaluated using the Disabilities of the Arm, Shoulder and Hand questionnaire), and vision quality (evaluated using the National Eye Institute Visual Function Questionnaire 25). Results Of 103 total subjects, 61.2% satisfied the definition of instillation failure. Instillation of the eyedrop other than at the cul-desac (76.2%) was the most frequent reason for failure, followed by contact of the tip of the eyedrop bottle (22.2%) and instillation of the same or more than two eyedrops in a single attempt (11.1%). Advanced age, a shallow cervical spine extension angle, weak pinching strength, poor motor dysfunction of the upper limbs, the degree of ataxia, poor best-corrected visual acuity, and visual field scores were significant risk factors for instillation failure. Vision quality may have some relation to instillation failure. Conclusion It is highly recommended that instillation failure be routinely investigated even among patients with adequate experience using eyedrops and that correct therapies are chosen in a patient-based fashion.

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Section: Introductionmentioning

confidence: 99%

Investigation of visual and physical factors associated with inadequate instillation of eyedrops among patients with glaucoma

et al. 2021

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“…Nonetheless, the structure of eye drop bottles has been improved in recent years, so that patients can instill one drop into their eyes accurately [1,2]. Therefore, the efficacy of topical IOP-lowering medications likely depends on the accuracy of self-instillation.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting eye drop instillation in glaucoma patients with visual field defect

et al. 2017

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BackgroundTo investigate the success rate of eye drop instillation in glaucoma patients with visual field defect as well as non-glaucoma volunteers. Factors that may affect the success rate of eye drop instillation were also evaluated.DesignA prospective, observational study.ParticipantsSeventy-eight glaucoma patients and 85 non-glaucoma volunteers were recruited in this study.MethodsOpen angle glaucoma patients with visual field defect as well as non-glaucoma volunteers were asked to video record their procedures of eye drop instillation using a 5-mL plastic bottle of artificial tear solution. Success of eye drop instillation was judged on video based on the first one drop of solution successfully applied on the cornea, by two investigators.Main outcome measuresSuccess rate of eye drop instillation in glaucoma patients and non-glaucoma volunteers. Factors related to success rate of eye drop instillation, such as visual field defect and clinical characteristics, were also analyzed using multivariable logistic regression.ResultsNo significant deference in mean age was observed between two groups (glaucoma: 64.5 ± 14.4 years, non-glaucoma: 60.9 ± 14.1 years, P = 0.1156). Success rate of eye drop instillation was significantly lower (P = 0.0215) in glaucoma patients (30/78; 38.5%) than in non-glaucoma volunteers (48/85; 56.5%). The most frequent reason of instillation failure in glaucoma patients was touching the bulbar conjunctiva, cornea, eyelid or eyelashes with the tip of the bottle (29.5%). Multivariable logistic regression analysis identified lower corrected visual acuity (VA) (≤ 1.0; odds ratio [OR] = 0.20, 95% confidence interval [CI] 0.04–0.93, P = 0.0411), lower mean deviation (MD) (< -12 dB; OR = 0.20, 95% CI 0.05–0.86, P = 0.0307) and visual field defect (VFD) in the inferior hemifield (OR = 0.11, 95% CI 0.02–0.34, P < 0.001) to be significantly related to instillation failure in glaucoma patients.ConclusionsSuccess rate of eye drop instillation was significantly lower in glaucoma patients than in non-glaucoma volunteers. Corrected VA ≤ 1.0, MD < -12 dB and/or VFD in the inferior hemifield may be related to failure of eye drop instillation.

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“…Eyedropper bottles with center-dimpled shapes showed greater force differences between the first and second drops, which means that this shape is useful for avoiding multidrop instillation. Yoshikawa et al reported that the dispensing time was mostly influenced by the diameter of the inner aperture of bottles [7]. When we decide on the design of eyedropper bottles, we have to pay attention to these points.…”

Section: Discussionmentioning

confidence: 99%

“…We have previously reported that glaucoma patients use on average two types of eye drops [6]. Some reports show different squeezing forces among eyedroppers [7–11], which may affect proper usage.…”

Section: Introductionmentioning

confidence: 99%

Wide Variation of Squeezing Force and Dispensing Time Interval among Eyedropper Bottles

Kashiwagi

2019

Journal of Ophthalmology

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Purpose. We aimed to investigate squeezing force and dispensing time interval of the first and second eye drops among a variety of eyedropper bottles and to clarify associated factors within these parameters. Methods. A total of 87 eyedropper bottles were involved in this study. We developed a squeezing force measuring system consisting of a syringe pump, digital force gauge, and custom-made test stand to measure the squeezing force and dispensing interval. The eyedropper bottle was housed in the system vertically, and measurements were repeated five times. We investigated the differences in squeezing force and dispensing interval by categories, including those that targeted ocular disease, brand or generic eyedroppers, shapes of eyedropper bottles, and the presence of a membrane filter inside the tip of the eyedropper bottle. Results. The mean squeezing forces of the first drop and the second drops were 8.3 ± 3.0 N and 10.4 ± 3.2 N, respectively. Both squeezing forces had a wide variation of more than threefold. A mean interval between the first and second drops was 3.1 ± 1.2 sec with a maximum difference of more than sevenfold. Round shapes of eyedropper bottles and the presence of filter membranes significantly increased the squeezing force. Conclusions. The squeezing force of eyedropper bottles was very wide, which may affect proper eye drop instillation. Unification of eyedropper bottles or developing mechanical aids may be useful for proper eye drop treatment.

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Influence of container structures and content solutions on dispensing time of ophthalmic solutions

Cited by 5 publications

References 7 publications

Investigation of visual and physical factors associated with inadequate instillation of eyedrops among patients with glaucoma

Investigation of visual and physical factors associated with inadequate instillation of eyedrops among patients with glaucoma

Factors affecting eye drop instillation in glaucoma patients with visual field defect

Wide Variation of Squeezing Force and Dispensing Time Interval among Eyedropper Bottles

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