Eye drop medications — managing glaucoma and other conditions
This article provides information about eye drop medications for older adults. Always use eye drops exactly as prescribed by your elder's eye doctor. Never skip doses or alter usage without medical guidance.
Eye drop medications present a unique challenge in medication management that people often overlook. Your parent needs to take glaucoma drops twice daily. They can see and understand the instructions. But their hands shake slightly. Their eyesight isn't sharp. They're not sure if the drop actually went in their eye or on their cheek. Within weeks, they've stopped using the medication because it feels impossible. This is far more common than you might think.
Glaucoma is a silent disease. Elevated pressure in the eye damages the optic nerve, causing gradual, painless vision loss. Most people with glaucoma don't feel anything wrong. They don't have symptoms until significant damage has already occurred. This makes glaucoma medications psychologically hard to take because your parent can't feel the medication working. They can't notice improvement. All they know is that they're supposed to put drops in their eyes every day to prevent something bad they can't see happening.
Eye drop medications exist for other conditions too. Some reduce pressure after cataract surgery. Some treat dry eyes. Some prevent infection. But glaucoma drops are the ones that require strict, long-term adherence. Missing doses isn't like missing a blood pressure pill for a day. It directly increases the pressure in the eye, causing damage that might be permanent.
The mechanics of instilling eye drops correctly sound simple but aren't. Your elder needs to tilt their head back slightly, look straight ahead or slightly upward, and pull down the lower eyelid to create a pocket. They need to hold the bottle or dropper at the right distance, not too close, not too far. They need to place one drop in that pocket without it sliding out. They need to close their eyes gently and keep them closed for a moment to allow the drop to be absorbed. If they blink immediately or squeeze their eyes shut, the drop is expelled.
For someone with arthritis in their hands, holding the tiny dropper is difficult. For someone with vision problems, judging the distance and seeing where they're aiming is hard. For someone with tremor, hitting their eye requires steady hands. For someone with limited dexterity or strength, the task becomes genuinely challenging.
If your elder is struggling with eye drops, don't just accept that they've given up. There are solutions. Some medications come in bottle-and-dropper form. Others come in pre-filled applicators that are easier to use. Ask the eye doctor or pharmacist if an easier-to-administer form exists. Sometimes switching formulations solves the problem entirely.
If dexterity is the issue, and hand shaking makes it impossible to keep the drop in, ask for a referral to an occupational therapist or ask the pharmacist for strategies. Some people use a mirror while instilling drops, which helps them see what they're doing. Some use a drop guide, a small device that helps position the dropper over the eye. Some have family members instill the drops for them.
Instilling drops for someone else requires learning the technique. You'll need to be gentle, patient, and confident. Your elder needs to tilt their head back, look up, and stay still. You'll pull down the lower eyelid, position your hand holding the dropper, and place a single drop in the pocket of the lower lid. This works better if you have good lighting and your hands are steady. It helps if you practice with artificial tears first so neither of you is stressed about medication being wasted.
If your elder refuses to let you instill the drops, and they can't do it themselves, you have limited options. Some eye doctors can instill drops during office visits, but that's not practical for daily medications. Some facilities can provide this service. Some home health agencies include medication administration. But fundamentally, your elder needs to be willing to accept help.
The other challenge with eye drops is remembering to use them. They're easy to forget because they're not part of the morning or evening medication routine that many older adults have. Drops go in the eyes, not the mouth. They're not mixed with other medications. Many people set them in a different place than other medications. This separation means they're frequently forgotten.
A practical system helps. Eye drops might go in a small container next to the sink in the bathroom, with a printed reminder. Or they might be part of a daily medication organizer that includes other medications. Some people set phone reminders twice daily. Some put a sticky note on the bathroom mirror. The reminder system needs to be something your elder will actually see and respond to.
Timing matters too. If drops are supposed to be used twice daily, twelve hours apart, they should be at predictable times. Morning after breakfast and evening before bed works for many people. Bedtime has the advantage that your elder can keep their eyes closed for longer afterward, increasing absorption.
The side effects of glaucoma drops are often overlooked because they seem minor. Some drops cause red eyes or irritation. Some cause headache. Some cause a metallic taste in the mouth because the drop drains down into the nose and back of the throat. Some cause systemic effects like changes in heart rate or blood pressure, particularly certain classes of drops. If your parent experiences new symptoms after starting eye drops, these might be medication-related. It's worth mentioning to the eye doctor.
Different classes of glaucoma medications work differently. Some reduce the amount of fluid produced in the eye. Some increase drainage of fluid. Some work through different mechanisms entirely. If one medication causes side effects, another class might work better. If one medication stops being effective over time, combining it with another medication often helps. The approach is individualized.
The psychological piece of using eye drops long-term shouldn't be minimized. Taking a medication for something you can't feel, for damage you can't see, to prevent something that might never happen to someone who has no symptoms, requires a kind of faith. Your elder needs to trust that the doctor knows what they're talking about. They need to believe that using the drops faithfully prevents serious vision loss. Without this belief, skipping doses becomes easy.
Helping them maintain this belief means occasionally reinforcing why the drops matter. Reminding them that glaucoma causes blindness, that early glaucoma has no symptoms, that drops prevent the damage, that once vision is lost it's permanent—these conversations matter. It's not about nagging. It's about helping them maintain the motivation to use drops despite the inconvenience.
Regular eye exams are part of the adherence picture too. At each exam, the eye doctor measures eye pressure and examines the optic nerve. If pressure is well-controlled, this reinforces that the drops are working. If pressure is elevated despite using the drops, it might signal that your elder isn't using them consistently, or that the medication regimen needs adjustment.
Your role includes making the medication easier to use, helping remember to use it, providing practical assistance if needed, and reinforcing why it matters. With these supports, most older adults manage eye drops successfully, and their vision is preserved.
Contact your eye doctor immediately if eye drops cause vision changes, severe eye pain, headache, or any allergic reaction. Never skip doses or alter the prescribed schedule without guidance from your eye doctor, as this directly affects eye pressure and optic nerve health.