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Tanya Martinez
November 2022

Primary Open Angle Glaucoma (POAG) is a chronic optic neuropathy that can lead to irreversible blindness if left untreated. In order to control intraocular pressure, hypertensive eye drops are prescribed to the patient. To effectively control eye pressure and in turn slow the progression of glaucoma, adherence and consistency in using the eye drops is crucial. Adherence can be challenging for patients as eye drops need to be instilled on a daily basis and during specific time periods. 

Image of a woman instilling eye drops

Due to the unprecedented nature of the COVID-19 pandemic, many people experienced disruptive health behaviours, such as a lack of compliance when taking medications. A study by L. Racette et.al1  relevantly investigated the impact of the pandemic on adherence to hypertensive eye drop medications in patients with primary open-angle glaucoma. 

The study found that there was a 15% reduction in hypertensive eye drop medication adherence from before the pandemic to 1 year later. Overall adherence levels pre pandemic were 83.6% and one year later, they dropped to 68%. As such, levels dropped below the acceptable standard for good adherence (80%) which puts patients at significant risk of vision loss associated with their glaucoma.  

Non-adherence was found to be influenced by factors such as difficulty adapting to adversity and a lack of accessibility to medication. For patients who were found to have difficulty adapting to the unprecedented nature of the pandemic, their non-adherence may have been caused by their diminished ability to focus on their medication regime. A lack of access to medication also decreased patient adherence as medication refills and prescription repeats were more difficult to obtain.

The COVID-19 pandemic has undoubtedly had a negative impact on medication compliance and adherence for some glaucoma patients. As a result, this has unfortunately led to poorer visual outcomes for patients with POAG. Therefore, it is so important that patients continue to adhere to their treatment schedule and maintain good medication compliance. Patients can also discuss with their clinicians, alternative methods of obtaining medications such as mail-orders from the pharmacy. Patients who have had difficulty with their eye drop medication schedule throughout the pandemic are also encouraged to prioritise visits to their eyecare provider to monitor for any vision change associated with their glaucoma. 

Racette, L. et al., 2022. The impact of the coronavirus disease 2019 pandemic on adherence to ocular hypotensive medication in patients with primary open-angle glaucoma. Ophthalmology, 129(3), pp.258–266. 

Image of Tanya Martinez
Article by Tanya Martinez
Glaucoma Australia Clinical Volunteer
Tanya is a Masters of Orthoptics student at the University of Technology Sydney. Tanya is highly passionate about patient-centred care with an emphasis on understanding social determinants of health and how environmental factors impact patient health and access to health services.