Purpose To assess the ability of a novel imaging device to allow physicians to personalize therapeutic regimens based on objective patient drop administration data. Methods A novel imaging system was used to record video of the drop technique of subjects in clinic (n = 25) or at home (n = 17) for 1 week. Video assessment by a reading center was compared with patient reporting and their prescribed regimen with respect to how many drops were applied and how many landed in the eye. Results Reading center assessment of both drops dispensed and drops landing in the eye was significantly different from the prescribed regimen in the clinic (P d = 0.005, P i o0.001, respectively) and at-home arms (P d = 0.003, P i o0.001, respectively). Conclusions This imaging system is a powerful tool to help physicians tailor patient therapy more accurately, to help researchers evaluate new drop therapies with objective rather than subjective data, and to potentially facilitate better patient training for improved drug delivery.