I have recently been diagnosed with suspected glaucoma and prescribed one eye drop a day.
Before this I had experienced runny eyes and had been referred to an optician by my GP. She found that I had dry eye.
Often now a short while after my eye drop the eye runs briefly. I am worried that the eye drop for glaucoma may be being washed away.
Has anybody experience of this problem and any ideas as to what I might do.
Thanks.
John
Hi there
A good technique is to pull down on the skin under your lower eyelid to create a pocket and aim the glaucoma drop towards the corner of your eye nearest your nose.
Then, once it's in, close your eye and place a finger on the corner of your eye for 30 secs to a minute. That should both keep the drop in your eye and also stop it from running down your tear duct and into your throat.
It can take a while to get the hang of it. One of my drops comes in a single dose unit and I found myself putting too much in at first, so it would spill down my cheek! And it's not always easy to just get one drop out of a bottle as some are more awkward than others but it become second nature after a while.
Hope that helps a little.
.... Great advice! Also I think don't worry too much if you do an extra drop - though you'll get through a bottle faster if your drops are in one. Apparently the eye can just hold one drop and any excess does just run down the cheek!
Hi.
Thank you for the advice, which is pretty much what I have been doing. However, the problem I have is that a few minutes after the eye drop a tear often rolls down my face. I don’t know whether or not it is the eye drop. And if not, whether it washes away the eye drop.
John
Hi, the first consultant I met advised me to always lie down doing the drops so after I put the drops in I do the finger press in the corner of my eyes and straightaway lie down. This helps prevent it running out of the eyes. I understand it only takes a couple of minutes for the medication to do its work. I do of course leave 10 minutes between inserting two different drops.
Hello. When you pull down your lower lid, put the drop in the centre of the pocket. If you put it closest to the nose it more will go into the tearduct. Then close your eye and press on your tear duct near your nose for up to 2 minutes. This does 2 things.
1. closing the lid keeps the drops in the eye
2.pressing on the tear duct reduces the risk of drops going through the tears duct to the back of the throat encouraging side effects.
The drops that run down your cheek will just be the excess. Just wipe it away with a clean tissue.
Thank you. Much appreciated.
I have become much more confident with the eye drops. However, I'm never sure whether the drop has gone into the pocket or straight onto the eye. The Moorfields video on administering eye drops with the Eyot (which I have stopped using) does not mention the pocket.
John
I have one slightly runny eye. I always blot it as dry as possible before puttingthe drops in, but sometimes it runs as you describe. However that eye does not seem to be faring any worse than the other one, so hopefully the drop is soaking in before the tears wash it away.
Thank you. Much appreciated.
I would suggest looking at it from another point of view.
First of all, it seems to me that you either have mild glaucoma or you don't, because that touch-the-front-of-the-eye measurement gives you a single number, which is either high or it isn't (less than 20).
The internal water-pressure inside your eye is in a steady state, between watery liquid entering the eye globe, and watery liquid leaving the eye globe. In the older-age type of glaucoma, it's the watery liquid _leaving_ the eye globe, which is being choked off, so that is why the internal water pressure rises. It's like the plug being put into the sink, water can get in but not out again.
Anatomically that water run-out I'm talking about, happens all at the front of the eye where your coloured-pupil circumference, joins itself on to the internal eyeball. That circumference is where all the exit pipes are.
Of course, normally the central black hole of your pupil gets bigger or smaller, as the brightness of outside light causes your pupil to open wide or to close up tight.
Your treatment like Pilocarpine drops, works by causing the coloured-pupil to tighten up, however much light there is, - so your central black pupil-hole gets smaller. This tightening also causes the outer edges, - the circumference ring, - of the coloured-pupil, to pull away from any physical bunching-up blocking the drainage pipes.
So I'm saying, you can _tell_ if your eye drops are working or not. If after using the drops, your central black pupil-hole gets smaller, the drops are working. If that black central hole stays big, they aren't working.
Again, it's not the central tightening that is doing the good, - it's the way that that central closing-up, also pulls the outer edges away from any bunch-up at the circumference.
Hi,
Thank you for taking the trouble to respond to my query.
I am not sure whether I fully understand your comments.
When you write that I “either have mild glaucoma or you don't” do you mean to say that I might not have glaucoma at all, or that I just might not have mild glaucoma? And what makes you think that?
And when you write “you can tell if your eye drops are working or not” do you mean that I can tell, or that the doctor or nurse can tell?
Best wishes,
John
Thanks, I'm sorry if I wasn't clear. I was trying to respond to your saying, that you had 'suspected' glaucoma. You know when the Ophthalmologist places a tester against the front of your eye?, - that tells him or her what the pressure is, inside your eye. A value of up to 20 or so is considered a normal pressure, and over that value indicates that the pressure inside the eye is unusually high. How much higher than normal the pressure is, is some indication of how worrying or not it is. A higher than usual pressure, is technically called having "glaucoma."
I was trying to suggest that if you have a higher than usual pressure, then that is by definition having"glaucoma." I'm not clear how that can be 'suspected' or not, if you follow me. Your doctor has prescribed a good treatment for you, so he or she must be convinced there's a problem.
I'm assuming that the problem is mild in your case, because your doctor has prescribed the mildest treatment, from what you say.
Glaucoma can have different causes. In older people, it is usually that the tiny drainage-canals, for fluid circulating out from the eye, get clogged uo a bit. Because these tiny drainage channels are partly covered by the outermost edges of the coloured iris, getting the iris to contract out of the way, is one way to help the eye to drain normally. The iris is a bit like a pair of window curtains, - when your curtains are opened in the morning, it leaves all the curtain material bunched-up at the window edges?
Perhaps I was being a bit too off-hand, but the whole essence of the treatment is to contract the iris so that your black central pupil, becomes small. It's that that pulls the bunched-up iris at the edges, away, and out of the way of the drainage channels.
The "opposite" type of eye drops are used to dilate the black pupil, to make it bigger, for different reasons, but I expect your doc has warned you that these opposite type of drops, might be risky in your case.
You can safely ignore my suggestion about observing the state of dilation or contraction of your black central pupils, I see that suggestion was not as helpful as I had hoped.
Best wishes.
I have seen a hospital ophthalmologist three three times about possible glaucoma and each time the pressure in the affected eye has been below 20. After the last consultation, when the eye drops were prescribed, the hospital doctor wrote to my GP that her diagnosis was “glaucoma suspect”.
By the way, my eye drops are Latanoprost, not Pilocarpine.
Yes, thank you, I was thinking of older treatments without checking, I'm sorry. It's reassuring that your actual pressures are less than 20, so 'suspected' must refer to the possibility of a normal-pressure glaucoma with some optic cupping and reduced peripheral vision. All-in-all In think i got off on the wrong foot with my suggestions here, I'm sorry. I'd like to think that that's unusual for me.
steroids and dry eye 
Right eye impacted by left eye
Help can’t get eye drops 
Clear glasses for dry eyes
Starting again! Why pressure in one eye only?
