Achieving optimal treatment outcomes in glaucoma requires patients to adhere to their medication regimens. Possible barriers to patients’ cooperation include the misunderstanding of a treatment’s importance or errors in applying instructions, forgetfulness, financial constraints and others. Due to the fact that glaucoma usually causes no apparent symptoms or pain, on the one hand, and the significant inconvenience that the eye drops used for glaucoma treatment can cause due to local irritation, on the other, patient compliance is a challenge. To address this challenge, we require strategies for improving adherence to glaucoma treatment. The importance of proper eye drop administration techniques cannot be overstated, particularly for vulnerable populations such as the elderly, the sick and the visually handicapped. Studies have shown that failure to comply with glaucoma treatment is a significant factor affecting disease progression, emphasizing the need for interventions that improve patient compliance. Educational interventions, medication reminders and the use of assistive devices such as eye drop aids have been shown to improve adherence to glaucoma treatment. By promoting strategies that can be used to enhance treatment adherence, healthcare providers can ensure that glaucoma patients receive the full benefits of their treatment plans, reducing the risk of disease progression. Many patients struggle with the complexity of their treatment regimens and the challenges of administering eye drops. This entry provides a comprehensive overview of the different barriers to patient adherence to glaucoma eye drop treatment, emphasizing the difficulties associated with eye drop instillation. This entry examines a range of eye drop aids available to patients, evaluating their modes of action, benefits, drawbacks and effectiveness in improving patient compliance. By providing detailed information on the barriers to adherence and the range of eye drop aids available, this entry aims to support healthcare providers in helping glaucoma patients to achieve better treatment adherence and outcomes.
Photorefractive keratectomy (PRK) has long been the method of choice for refractive surgery in pilots, and was FDA approved for U.S. Air Force aviators in 2000. We retrospectively reviewed the medical records of 16 male combat pilots (mean age 25.0 ± 5.5 years) who had undergone bilateral laser refractive surgery with surface ablation (alcohol-assisted PRK: 81.25%, transepithelial-PRK: 18.75%), and who had a mean baseline spherical equivalent (SE) of −2.1 ± 0.7 D in the right eye, and −2.0 ± 0.7 D in the left. The mean follow-up was 8.4 ± 6.6 months. On the last visit, the uncorrected visual acuity (UCVA) had improved from 0.75 ± 0.33 logMar to −0.02 ± 0.03 logMar (p < 0.001), and from 0.72 ± 0.36 logMar to −0.02 ± 0.05 logMar (p < 0.001), for the right and left eyes, respectively. The percentages of participants with a right eye UCVA of at least 0.0, −0.08, and −0.18 logMAR (6/6, 6/5, and 6/4 Snellen in meters) were 100%, 37.5%, and 6.2%, respectively, and for the left eye, 93.7%, 43.75%, and 6.2%, respectively. No complications occurred. This is the first study to assess refractive surgery outcomes in a cohort of Israeli combat pilots. Surface refractive surgery effectively improved UCVA and reduced spectacle reliance for the members of this visually demanding profession.