If the thought of using eye drops makes your hands tremble and your heart race, you're not alone. Many children and adults require prescription eye drops on a daily basis, but few feel confident using them. Learning the proper technique is the first step, but some patients need extra help managing their fears.
Here are some ophthalmologist-approved tips to ease eye drop anxiety and improve success.
Yes, you really DO need to use your eye drops
Eye drops can help treat common eye conditions such as myopia, dry eye disease, glaucoma and presbyopia. Ophthalmologists also prescribe drops to prevent infections and promote healing after eye surgery, and to dilate or numb the eyes during a comprehensive eye exam.
But anxiety, unsteady hands and other challenges keep patients of all ages from getting the correct amount of medicine into their eyes.
“In the best case, missing needed eye drops means the patient doesn’t get the benefit they are looking for and may have discomfort or poor visual function. But in the worst case — for patients who have glaucoma, uveitis or myopia, for example — not getting drops in can put them at risk for permanent vision loss,” said ophthalmologist and Academy member J. Kevin McKinney, MD, who specializes in glaucoma treatment.
Skipping eye drops after surgery can also compromise your health.
“For post-operative patients, not getting anti-inflammatory and antibiotic drops could result in delayed healing or serious infections,” adds Laura B. Enyedi, MD, an Academy member and pediatric ophthalmologist.
Convincing children to let you insert eye drops
Infants and babies can be swaddled to help ease drop delivery, but preschoolers and elementary school-aged children are often the toughest patients. They’re old enough to understand what’s happening, says Dr. Enyedi, but not mature enough to reason with. Children and teens with special needs, including autism or sensory processing disorders, may put up the biggest fight.
Tips for giving children eye drops without drama or trauma:
- Before you start, review the proper way to insert eye drops so that you can do it safely and effectively.
- Be honest with children. Most drops do burn a little, especially after surgery, and it’s important to maintain the child’s trust.
- Get a partner to help. One person can restrain the child while the other puts drops in.
- Act relaxed. Younger children will follow your cues and body language.
- Go in quickly with overwhelming force for uncooperative children; bargaining can increase anxiety for both the parent and child and a reluctant child is not likely to ever be “ready”.
- Show and tell on a favorite toy for a child who is somewhat cooperative but nervous.
- If the child won’t open their eyes, have them lay down flat and put a puddle of drops in the inside corner of the eye. Then, use two hands to pull the upper and lower lids apart to help the medicine go in.
- If the child is a sound sleeper, you can apply drops gently during a nap or at night.
- If you’re worried about over-medicating, rest assured that it’s generally safe if more than the required number of drops make it into the eye. You can also decrease the amount that is absorbed by pressing with your finger on the inside corner between the eye and the nose after administering drops.
- Ask your doctor if an ointment-based alternative is available. Warm the tube in your pocket or hand for several minutes, then squeeze a pea size amount onto the eyeball or inside the lid.
How can adults overcome a fear of eye drops?
Adults struggle with a few different types of eye drop anxiety. Some dislike the feeling of drops in their eye and feel squeamish about applying them. Others worry that the drops won't make it into their eye, or that they'll insert more medication than needed.
This is especially true among elderly adults who need to treat conditions such as glaucoma with daily eye drops.
Eye drop tips for anxious adults:
- Feeling confident is the first step! Learn the proper way to insert eye drops so that you can do it safely and effectively.
- Anxious about manipulating the bottle?
- Lay down or lean your head back as far as is comfortable.
- Hold the eye drop bottle with your thumb and first two fingers.
- Put the other two fingers of your hand on your nose for stability, then squeeze the drop into the eye.
- If you have bad aim, close the eye and put the drop in the inside corner, then blink gently until you feel the drop roll into the eye.
- If you're worried you won't be able to tell if the drops make it inside your eye, keep the bottle in the fridge so the medicine is cold, giving you better sensation when the drop lands.
- If you're afraid that the medicine will bounce out of your eye or roll down your cheek, know that each drop contains about 10 times more medicine than can fit in the tear film. What you’re likely feeling is the excess that your body doesn’t need.
Technology to the rescue
If these suggestions aren't enough to ease your fears, ask your doctor for help. Eye drop delivery devices can provide much-needed relief for anxious patients. And some eye conditions can be treated with medications other than eye drops. Here are a few of the available options.
Devices to help aim and squeeze eye drops
If you've tried the tips above and you're still worried about getting the drops into the right place, ask your ophthalmologist about inexpensive, low-tech drop application devices that can help you position the bottle, guide the drop or squeeze the bottle to release drops.
Palm-sized spray devices to help deliver eye drops
New technology may soon allow you to spray or mist your eye medicine with the push of a button, rather than trying to place a drop. Two new devices — the Optejet and the AcuStream — are hand-held dispensers that deliver a micro-dose of medicine into the eye while seated or standing up. Both devices are in clinical trials.
Implants and injectable medicines may avoid the need for eye drops
Some eye conditions can be treated with dissolvable medicines and implanted drug reservoirs that automatically deliver tiny doses of medicine into the eye over a period of weeks or months.
Today, ophthalmologists can prescribe slow-release steroid injectables and punctal inserts to calm inflammation after eye surgery. Glaucoma can be treated using dissolvable medications such as Durysta. Implants that deliver drugs such as Ozurdex are available to treat macular edema.
The U.S. Food and Drug Administration recently approved a refillable implant for wet AMD. This type of technology may soon be used to treat glaucoma and other retinal diseases, offering patients an alternative to drops.