New device addresses issues with eye drop delivery, improving eye drop safety and compliance.
Retina Health Center has been issued design patents for a new eye drop imaging device developed by Eaton and his colleagues at Retina Health Center. The patents, No. D750773 and No. D751702 and were awarded on March 1 and 15 by the U.S. Patent and Trademark Office. The utility patents on the device are still pending.
Understanding patient ability to properly instill their eye drops and comply with a prescribed regiment at home is critical in helping eye doctors select the right treatment option for a patient. Until recently, getting accurate data on patients’ at-home drop installation has not been possible. Indirect measures of eye drop use have been used such as weighting the bottle to determine how many drops were used or electronic monitoring systems that can determine if the bottle was picked up or inverted, but existing systems have not been able to determine if the drop(s) actually got into the eye. A patient can think they are complying but if they forget to take the top off the drop bottle, or they miss their eye and the drop lands on their lid or face, they may not be receiving the benefit of the medication they have been prescribed. To monitor patients’ eye drop technique and compliance, Retina Health Center physicians developed a new compact imaging device to allow physicians to monitor patient eye drop use at home, as well as during patient visits at Retina Health Center offices.
Using the newly developed imaging system created by Retina Health Center, the physicians have launched the first-ever at-home studies to evaluate the drop delivery and compliance of patients at home. Prior to use at home, patients were trained on the use of the device in the clinic and then completed the in-clinic portion of the study.
A collaborative study between Retina Health Center and the Konowal Vision Center followed 37 post-surgical cataract patients in the clinic phase and 38 cataract surgical patients participated in the home study. Following the videotaping, researchers compared the actual video to the patients’ reporting of the number of drops applied and how many drops landed in the eye. Patients were found to consistently underestimate the number of drops they applied while trying to get a drop in their eye, and overestimated the number of drops that actually landed in their eye.
Retina Health Center also evaluated the number of patients that can properly apply a drop, which is to deliver one drop per application without the tip coming in contact with the eye lashes, the eye itself or the skin. Nearly 90 percent of patients were not able to properly deliver the eye drops at least once during the clinic phase. In the at-home phase, none of the subjects were able to perform proper drop applications for every attempt during their regimen.
“The results show that there is great opportunity to improve drop delivery with the direct feedback patients can get from our easy-to-use device,” said Eaton. “This pilot study has confirmed previous reports of difficulties that patients experience when administering eye drops, and has further shown that the imaging device can provide a unique insight for physicians and patients alike. During drop administration, patients often blink and the drops may land on the lid and/or the conjunctiva, all of which happened quickly, making it very difficult to determine what exactly happened by the patient. Our study shows that the imaging system can provide physicians with an objective measurement of when and how many drops are getting into the patient’s eye. We are hoping that the imaging system will help physicians tailor therapeutic decisions more accurately for each patient and can help researchers evaluate new drop therapies. We are optimistic that much the way athletes view videos of themselves to improve their game, that patients, physicians and physicians’ staff will be able to use the videos to improve their drop technique and that this will result in better outcomes and less waste for people throughout the world.”
An Institutional Review Board (IRB)-approved study is currently under way to evaluate if the system can be used to improve drop delivery in patients that have difficulties with drop installation and compliance. In addition to helping patients, physicians and their staff, the device may help manufacturers improve their understanding of how the eye drop bottle shape and tip shape can affect a patient’s drop delivery and compliance, and can help them determine if medications they are evaluating for FDA approval are being used at the proper time and are actually properly getting into the patient’s eye.
