title: An upright eyedrop bottle: accuracy, usage of excess drops, and contamination compared to a conventional bottle.
abstract: OBJECTIVE
  This study tested the feasibility of using an upright eyedrop bottle (UEB), a device designed to assist patients with eyedrop placement without reclining their head.
  
  
  METHODS
  Experienced eyedrop users were enrolled who answered "yes" to the question, "Do you ever have trouble getting your eyedrops in?" After being shown a multimedia presentation and answering a questionnaire regarding eyedrop usage, participants were observed instilling eyedrops. Participants were instructed to instill a single eyedrop in each eye with both a standard bottle and the UEB. They repeated this process three times. With each trial, the amount of time taken to instill drops was recorded, as well as whether a drop landed in the eye (accuracy), if excess drops were used, and if the bottle tip was contaminated.
  
  
  RESULTS
  Forty participants were enrolled, with an average age of 72.4±8.9 years; the majority were females (24 females). Thirty-four participants had been using eyedrops for at least 1 year. The time required to instill eyedrops was significantly less with the UEB in the second and third trials. There was no difference in accuracy between the conventional bottle and the UEB in the left or right eye in any trials. Significantly more participants used excess number of drops while using the conventional bottle in both the left and right eyes in all three trials. The bottle tip was never contaminated with the UEB. Depending on the trial and the eye, the conventional bottle was contaminated by between 42% and 53% of participants.
  
  
  CONCLUSIONS
  The UEB has the potential to assist patients with eyedrop placement. Although there was no difference in accuracy between the UEB and the conventional bottle, the UEB was associated with less use of excess drops and less contamination of the bottle tip, compared to the conventional bottle.
authors.affiliation: Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Isaiah J
authors.initials: IJ
authors.lastname: Davies
authors.affiliation: Metrolina Eye Associates, Charlotte, NC, USA.
authors.forename: Ninita H
authors.initials: NH
authors.lastname: Brown
authors.affiliation: Department of Ophthalmology, University of Washington, Seattle, WA, USA.
authors.forename: Joanne C
authors.initials: JC
authors.lastname: Wen
authors.affiliation: Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Stinnett
authors.affiliation: Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology; Wallace H Coulter Department of Biomedical Engineering, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Kubelick
authors.affiliation: University of California Davis Health System Eye Center, Sacramento, CA, USA.
authors.forename: Roma P
authors.initials: RP
authors.lastname: Patel
authors.affiliation: EG-GILERO, Durham, NC, USA.
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Benokraitis
authors.affiliation: Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Latoya
authors.initials: L
authors.lastname: Greene
authors.affiliation: Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Curry
authors.initials: C
authors.lastname: Cheek
authors.affiliation: Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA; Health Services Research & Development, Durham VA Medical Center, Durham, NC, USA.
authors.forename: Kelly W
authors.initials: KW
authors.lastname: Muir
keywords: compliance; glaucoma; medical devices