What the Patient Needs to Know

• Glaucoma is a lifelong disease. It is not cured like an infection. Drops must be taken every day.

• Never stop medication unless advised to do so by your physician. Glaucoma causes damage to the eye even if you "feel" fine. Always return for your scheduled pressure checks.

• Some drops sting when you put them in. However, if drops cause eyes to sting for prolonged periods, notify your doctor.

• Gels and ointments should be the last medication put in the eye if a series of medications is used.

• Wait a minimum of 5 minutes between drops if multiple drops are used.

• Gels and ointments blur vision. Putting them in just before sleeping reduces this inconvenience.

• After using glaucoma drops, close your eyes and gently press your forefinger against the corner of your eye, next to the nose. This seals off the tear-drainage system, keeping the medication on the eye. It also helps reduce the chances of the drug entering your body system, thereby decreasing side effects.

• Follow the doctor's directions exactly.

• Keep a schedule of when you take your medication. This is helpful to the doctor.

• Have others remind you to take your medication. Have someone else put the medicine in for you if you have a hard time.

• To help you remember to use your medicine and to make things handy, keep a bottle of drops in the places where you usually are when drop-time rolls around. For example, keep a bottle at home, one in your desk at work, one in your workshop, etc.

• Does not stop medication because of the cost. Ask your doctor about less costly alternatives.

• Taking more than the prescribed dose will not help. It may hurt and is more expensive.

• Take your drops on schedule even when you have an appointment for a pressure check.

• Never run out of medication. Be sure to get refills before the bottle or tube is empty. A weekend without medication is a weekend where your pressure runs high. That could mean a weekend where your optic nerve is irreparably damaged.

• For proper drop control, some medications are packaged in bottles that are larger than necessary, giving the appearance of being half-full when purchased. This is not a manufacturing error. The amount of drug in the container is the proper amount.

• Advise your physician if redness, swelling, or scaling of the eyelids occurs because this may indicate a sensitivity to the medication.

Note: A few patient education notes regarding selected medications are found at the end of this chapter. Every patient should be advised about the possible side effects of every new drug he or she is given.

cap. A combination of 1% epinephrine and pilocarpine is available as E-Pilo®. This drug is designated by the numbers 1 through 6, the numbers referring to the percentage of pilocarpine.

Dipivefrin 0.1% (Propine®) is a pro drug of epinephrine. It crosses the cornea more easily than epinephrine and is converted into epinephrine in the eye. Its indications and use are the same as epinephrine. Dipivefrin is packaged with a purple cap.

Both drugs arouse the sympathetic system. They should be used with caution in the presence of cardiovascular disease, diabetes, hyperthyroidism, or asthma. Overall, due to its formulation, dipivefrin is safer than epinephrine, but the same relative warnings exist. Ocularly, both are quite uncomfortable after instilling and may cause conjunctival redness. Over time, hypersensitivity is not uncommon, and pigmented spots, called adrenochrome deposits, may be seen in the conjunctiva.

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