The relationship between glaucoma medication adherence, eye drop technique, and visual field defect severity

Ophthalmology. 2011 Dec;118(12):2398-402. doi: 10.1016/j.ophtha.2011.05.013.


Objective: The purpose of the study was to examine (1) how patient adherence and eye drop technique were associated with visual field defect severity and (2) how general glaucoma adherence self-efficacy and eye drop technique self-efficacy were related to visual field defect severity.

Design: Cross-sectional study conducted at a single private practice site.

Participants: Patients using eye drops for their glaucoma.

Methods: Subject adherence to glaucoma medications through Medication Events Monitoring System (MEMS) devices were measured, and eye drop instillation technique was assessed by video recording. General glaucoma medication adherence self-efficacy was measured using a 10-item scale, and eye drop technique self-efficacy was measured using a 6-item scale. Multivariate logistic regression was used to analyze the data.

Main outcome measures: Visual field defect severity.

Results: Patients who were less than 80% adherent according to the MEMS devices were significantly more likely to have worse defect severity. Patients with lower scores on the general glaucoma medication adherence self-efficacy scale also were significantly more likely to have worse defect severity. Eye drop technique and eye drop technique self-efficacy were not related significantly to visual field defect severity.

Conclusions: Eye care providers need to assess patient adherence and to work with those patients with poor adherence to find ways to improve their ability and self-efficacy in using their glaucoma medications.

Financial disclosure(s): Proprietary or commercial disclosure may be found after the references.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Ophthalmic
  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / administration & dosage*
  • Cross-Sectional Studies
  • Female
  • Glaucoma / drug therapy*
  • Glaucoma / ethnology
  • Humans
  • Male
  • Medication Adherence*
  • Middle Aged
  • Ophthalmic Solutions / administration & dosage*
  • Self Administration
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome
  • Video Recording
  • Vision Disorders / physiopathology*
  • Visual Acuity / physiology
  • Visual Field Tests
  • Visual Fields / physiology*


  • Antihypertensive Agents
  • Ophthalmic Solutions