2020–2021 BCSC Basic and Clinical Science Course™
Chapter 12: Medical Management of Glaucoma and Ocular Hypertension
General Approach to Medical Treatment
Administration of Ocular Medications
Patients should be shown how to instill eyedrops properly and should be given instruction on nasolacrimal occlusion, which can be used to reduce the systemic absorption of topical ocular medications and to prolong their ocular contact time. Directing the patient to close their eyes for 1–3 minutes after instillation of the eyedrop will also promote corneal penetration and reduce systemic absorption of the drug by reducing the flow of medication-containing tears into the nasolacrimal drainage system.
Proper instillation procedures are especially important with the use of β-blockers, α2-adrenergic agonists, and topical CAIs (to minimize the likelihood of taste disturbance). In addition, these procedures ensure that there is a sufficient amount of time between the instillation of different medications; eyedrops that need to be administered at the same time should be separated by 5 minutes to prevent washout of the first drug by the second. Patients should be taught how to space their medications, and instructional charts should be given. A dosing aid device may also be considered, especially for patients who live alone or who are unable to successfully instill eyedrops.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.