In my career, I have been lucky enough to meet wonderful and interesting eyecare providers with unique and varied passions apart from their profession in eye care.
I know optometrists and ophthalmologists who—besides being superb clinicians and surgeons—are musicians, artists, explorers, and scientists.
For example, Jay Galst, MD, is a world-renowned collector of coins and medals that are related to the eye. Robert Goldberg, OD, is a classically trained opera singer who once sang the National Anthem at Yankee Stadium. Further, Veronica Ruelas, OD, is a master yoga instructor and creator of a line of yoga-related clothing and jewelry. I am also privileged to know tinkerers and inventors such as Paul Karpecki, OD, FAAO; the late Sol Leibowitz, MD; and Julius Shulman, MD.
Previously from Dr. Mastrota: 5 things you need to know about TFOS DEWS II
Julius Shulman, whom I have known for over 30 years, maintains two vibrant private ophthalmology practices in NYC—he is a Renaissance man. A lover of theater and music, he produced a Broadway musical. As an inventor, Dr. Shulman has brought to market a product to assist pediatric, adult, and even pet patients instill eye drops.
Eye drop challenges
As ODs, we are fully aware of the challenge patient compliance with prescribed eye drops. To assuage the battle of compliance, eye drop manufacturers are assiduously working to devise drug delivery systems that reduce or eliminate patients’ engagement in the instillation of their prescribed therapy. But until ODs no longer use eye drops, drops remain our primary mode of drug delivery.
With respect to ocular drug usage—particularly the application of eye drops—patient adherence to therapy is challenged by:
• Drug cost
• Remembering to apply the drug daily
• Iatrogenic drug discomfort or irritation
• Poor vision1
Contamination of the dropper tip is a consideration. Sometimes, poor communication or understanding of medication use is the culprit of a patient’s non-adherence to therapy.2
Additionally, poor dexterity, grip strength, and poor aim may make eye drop instillation difficult with product waste common. In 1976, Fraunfelder—considering gravity, blinking, lid closure, head position, and area of eye drop drug instillation on ocular contact time—investigated the best way to instill eye drops. To date, ODs recommend the same instructions outlined in this study.3,4
Innovation in instillation
I have evaluated gadgets to squeeze dropper bottles and guide drops into the eye. Patients have found these gizmos of limited utility.
Through the laws of physics, Magic Touch is a simple, ingenious device that assists patients in instilling eye drop medications. Magic Touch, made of medical-grade, anti-microbial silicone (infused silver ions prevent contamination) looks like a thimble.5
At the very top of the fingertip applicator is a tiny reservoir. Surface tension holds a single drop of fluid at the top of the applicator. As one would apply a contact lens, the fingertip device is brought close to the eye. Once the drop at the tip of the applicator touches the lid margin or the lid cul-de-sac, capillary action delivers the eye drop to the ocular surface.
Patients do not need to lie down or tip their heads to use the applicator; they self-guide the balanced drop to their eye.
A tiny gadget may be the answer to help patients with prescribed therapy. Sometimes, life-changing, novel inventions can drive compliance and therapeutic success for your patients.
1. Hennessy AL, Katz J, Covert D, Protzko C, Robin AL. Videotaped evaluation of eyedrop instillation in glaucoma patients with visual impairment or moderate to severe visual field loss. Ophthalmology. 2010 Dec;117(12):2345-52.
2. Slota C, Sayner R, Vitko M, Carpenter DM, Blalock SJ, Robin AL, Muir KW, Hartnett ME, Sleath B. Glaucoma Patient Expression of Medication Problems and Nonadherence. Optom Vis Sci. 2015 May;92(5):537-543.
3. Fraunfelder FT. Extraocular fluid dynamics: how best to apply topical ocular medication. Trans Am Ophthalmol Soc. 1976; 74: 457–487.
4. Schuster, B. Is There a “Best Technique” for Putting in Eye Drops? Glaucoma Research Foundation. Available at: http://www.glaucoma.org/gleams/eyedrop-techniques-questions-and-answers-.... Accessed 9/6/2017.
5. Magic Touch Eye. Experience the Magic. Available at: https://magic-touch-eye.myshopify.com/. Accessed 9/6/17.