Patient acceptance and attitude toward an alternative method of subconjunctival injection for the medical treatment of glaucoma

J Glaucoma. 2013 Mar;22(3):190-4. doi: 10.1097/IJG.0b013e318237c6c4.


Purpose: Nonadherence to glaucoma medications may be a major cause of treatment failure. We examined the acceptance of glaucoma patients toward a possible new route of administering glaucoma medication by subconjunctival injection.

Patients and methods: Patients were recruited from specialist glaucoma clinics on a voluntary basis. Trained interviewers administered a 30-item questionnaire and an information sheet with details of an alternative subconjunctival injection route involving injections at 3-month intervals. Outcome measures regarding acceptance of the new procedure, social situational factors, disease factors, and treatment factors were assessed.

Results: A total of 151 patients participated in this study. Of the 151 patients 112 (74.2%) were willing to have their glaucoma medication given by the new method of subconjunctival injection, 101 of 112 (90.2%) were willing to accept it at the same cost as their present medication, and 87 of 101 (86.1%) were willing to accept it even at a higher cost. These patients tended to be on a greater number of medications (P=0.006), and medicating more frequently in a day (P=0.003). Nine of 10 (90%) patients who were admitted to nonadherence were willing to accept subconjunctival injections at 3-month intervals in place of their topical medication.

Conclusions: Our study found that 74% of glaucoma patients were willing to accept an alternative form of glaucoma treatment through 3-monthly subconjunctival injections. A large proportion of patients who were admitted to nonadherence to topical medication were willing to consider this alternative method of medication. Our findings are helpful when developing patient-acceptable drug-delivery regimes, which may alleviate the need for daily medication.

MeSH terms

  • Administration, Topical
  • Aged
  • Antihypertensive Agents / administration & dosage
  • Antihypertensive Agents / therapeutic use*
  • Attitude to Health*
  • Conjunctiva / drug effects*
  • Cross-Sectional Studies
  • Drug Administration Routes
  • Female
  • Glaucoma, Angle-Closure / drug therapy*
  • Glaucoma, Open-Angle / drug therapy*
  • Humans
  • Injections
  • Intraocular Pressure / drug effects
  • Male
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Compliance
  • Surveys and Questionnaires


  • Antihypertensive Agents