Tips on Using Eye Drops

Much like using puffers or nasal sprays, most individuals do not use eye drops optimally. The majority of eye drop applicators are small bottles with a removable cap on top. When the cap is removed and the bottle is turned upside down, gentle squeezing of the bottle allows a drop to fall off the applicator tip. Never forget that all eye drops are sterile and the applicator tip must never touch the eye or the eyelid, as bacterial contamination will result. Although eye drops are certainly not a primary treatment for allergic conjunctivitis (the red, watery, and itchy eye), which occurs often with hay fever or with pet allergy, they are very useful as an additional measure to rapidly control eye symptoms. Some individuals cannot tolerate anything being put in their eye and for these individuals oral medication or allergy shots are the only options available. There is huge variation in how often local eye medication should be used. In general, most eye drops should be used several times a day while eye ointments can be used less frequently as the ointment lasts longer. However, some newer drops have been formulated to be used only twice daily. Make sure you carefully read the instructions for your specific drops and follow these directions. You can see clearly through all eye drops used for allergy, but ointment causes blurring (often only used at bedtime). Almost all eye drops cause a certain amount of discomfort-burning for a few seconds immediately after being instilled. If you feel you are experiencing increasing discomfort or increasing redness-swelling in the eye immediately after using local eye medication, you must stop this medication and talk to the prescribing physician. It is possible to be allergic to the medication in the eye drops. It is also possible to be allergic or have an irritant reaction to the preservative(s) in the eye drops. Preservatives are required to maintain sterility and stability of the medication. Some individuals automatically cry (produce copious tears) after using an eye drop and this requires the eye drop being reapplied (at least once more) or alternative therapy.

Adult Technique

There are many techniques available. The one I prefer involves the individual looking in a mirror. With one finger the lower eyelid is pulled gently downwards. This creates a groove behind the lower eyelid where the eye drop can be instilled. Carefully drop one single drop into the groove behind the lower eyelid. Continue to hold the lower eyelid and do not move the position of your head. Using your eyes only, attempt to look at the floor and then up at the ceiling and then down at the floor without moving your head. This allows the drop of medication to be spread across the entire surface of the eye. Gently release the lower eyelid and close this eye. There should be no liquid showing on the outer eyelid (in other words you should have placed a single drop into the eye and spread this across the surface of the eye). All to often medication is put into the eye and when the lower eyelid is released the medication simply flips out of the eye and sits on the outer eyelid. There is no need to put more than one drop into each eye if it is done properly as the eye can only hold one drop - all further drops merely are lost as a teardrop. Repeat this procedure for the other eye.

Child Technique

Although similar to adult technique, the age and cooperation of the child plays a huge role. Ideally, have your child look upward, gently pull the lower eyelid down and have your child look towards the top of their head. Drop a single drop into the lower eyelid groove and ask the child to close their eye while you gently and slowly let go of the lower eyelid (so the drop does not flip out of the eye). Having the child look towards the top of their head allows the cornea to rotate upwards (the cornea is the area you see through and has very sensitive nerves) so the eye drop will not irritate the eye as much and also means your child cannot see the eye dropper. In very young children often both parents are required, one to hold the head and the other to instil the drop. If the drop flips out, the whole procedure should be repeated until you are sure a drop has stayed in the eye.

Bruce Sweet M.D., 2001