Association of Eye Drop-Treated Diseases and Conditions That Can Impair Eye Drop Self-Administration.

Objective: Eye drops are often first-line treatment for glaucoma and dry eye disease (DED). Unfortunately, proper eye drop self-administration is difficult, and this is likely magnified in persons with comorbid rheumatological, neurological, or cognitive disorders. This study investigates the association between ocular conditions often treated with eye drops (glaucoma and DED) and medical conditions that may impair proper eye drop self-administration.

Design: A retrospective database study.

Participants: From 6 health systems, 1 446 229 patients participated in the Sight Outcomes Research Collaborative between January 2012 and December 2021.

Methods: We determined the proportion of patients with glaucoma or DED with medical conditions that may limit proper eye drop self-administration and created multivariable logistic regression models assessing associations between glaucoma or DED and comorbid conditions.

Main outcome measures: Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) of glaucoma or DED.

Results: Among 247 899 patients with glaucoma (mean [standard deviation] age: 60.1 [15.1] years, 56.2% female, 19.5% Black), 106 927 (43%) had ≥ 1 comorbid condition that could affect eye drop self-administration. Among 321 941 patients with DED (mean [standard deviation] age: 55.9 [16.1] years, 66.4% female, 12.6% Black), 156 811 (49%) had ≥ 1 such condition. Patients with ≥ 1 impairment affecting eye drop self-administration had 17% greater odds of glaucoma (aOR: 1.17, CI: 1.16-1.18) and 66% greater odds of DED (aOR: 1.66, CI: 1.65-1.68), compared with other patients. Persons with 2, 3, and ≥ 4 conditions that may affect eye drop administration had 27%, 39%, and 53% higher odds of glaucoma, respectively, compared with persons without such conditions (P < 0.0001). Persons with 2, 3, and ≥ 4 health conditions that may impair eye drop administration had 76%, 121%, and 156% higher odds of DED, respectively (P < 0.0001).

Conclusions: Nearly half of all patients with glaucoma or DED have ≥ 1 medical condition that may impair eye drop self-administration. Clinicians should assess patients' physical and mental capacity to self-administer topical ocular therapy. Some patients may benefit from alternative therapies that reduce or eliminate the need for eye drops.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.