Tissue Press Method for Instilling Eyedrops

[Blackie1234]

Hello from Canada. While I am new here, I am not new to glaucoma. I’ve been taking drops for 10 years and have had two SLT surgeries. Covid delays have really slowed testing and seeing an opthamologist so I am really not sure about the progression of my glaucoma. I have to wait until April for a visual field test.

Like many if you, I have red irritated sore eyes from timolol drops to the point that doing punctual occlusion after putting in eye drops can be uncomfortable., especially lately in my right eye.

I came across this article which talk about the “tissue press method” which obviates the need for punctual occlusion after instilling eyes drops. Anybody heard of, or read this article. Seems to be a big benefit especially for those who have to put in more than on drop

Hope the link works!

researchgate.net/profile/Be...

[Jon1988]

I come across that awhile ago and tried it out whilst monitoring at home with my tonometer, it was fine for a few weeks and then pressure started creeping up so I’m skeptical and don’t do it. On the contrary, if I do punctual occlusion for two minutes my pressure is good. I experimented with only holding for one minute, but again it made the drops not as effective for me.

[Blackie1234 in reply to Jon1988]

Thanks for your response. It’s good to know that your pressure went up using this method so not the best for you. I’m wondering though if it is an effective in preventing systemic absorption which is cited as the main benefit.

[Derfahrer in reply to Jon1988]

Similar experience for me. My pressures were higher using the tissue press method, not a lot, maybe 1-2mmHg higher, but that was enough for me to go back to the punctal occlusion method

[Helen_GlaucomaUK Administrator]

Hi. Yes, I have read about this technique of closing off the tear duct. If this way suits you better, then by all means give it a go. From looking at the pictures of someone doing this with a tissue, I would say that they aren't directly putting a small amount of pressure on the tear ducts as such. It shouldn't obviate the need, just that you are using a tissue instead of your finger. The pressure you apply doesn't have to be too hard.

I would suggest that you also try to get your Timolol drops changed to a different drop, to see if this stops the redness and discomfort in your eyes

[Blackie1234 in reply to Helen_GlaucomaUK]

thanks for your response. The method is not about putting any pressure on the tear duct. The balled up Kleenex pressed against the eye for only 2 seconds is to remove excess drops at the eyelid margins, thereby reducing what can be absorbed through the nose.

I’ll ask about changing drops at my next appointment.