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Dr. A. Sydney Williams demonstrates how to instill medication eye drops for treating glaucoma.
A. Sydney Williams, MD: Stephanie has just instilled the eye drop in her eye and she’s performing punctal occlusion - she’s closing the tear duct so that the eye drop doesn’t enter the throat and get taken up by the bloodstream. That can cause side effects throughout the body.
Although these are eye drops that are placed only in the eye, side effects throughout the rest of the body systems can be felt in some cases. Punctal occlusion should be carried out for a period of 3 minutes to prevent side effects. It can also be done by simply closing the eye. It’s equally effective as pushing the tear ducts closed with your finger.
The tear ducts are located in the inner corner of the eyelids. I have patients generally close their eyes because it’s simpler. I usually only use punctal occlusion when using beta blocker eye drops, which are notorious for systemic side effects.
So in placing eye drops, it’s important to create a big space so that the eye drop gets in the eye. I suggest that you pull the lower eyelid down while looking up, and brace the hand that’s holding the bottle against the hand that’s holding the eyelid. And then as you look up, squeeze the bottle so that the drop enters the eye.
If your neck is stiff and you can’t look up, you should instill the drops while lying down. It’s important that you learn how to put the drops in yourself. Practice makes perfect, and practice can be carried out with any number of artificial tear drops.
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A. Sydney Williams, MD is a Board-certified ophthalmologist, glaucoma specialist and surgeon in private practice at the San Francisco Eye institute in San Francisco and San Mateo, CA. He is an Associate Clinical Professor at the University of California in San Francisco in the Department of Ophthalmology and past director of glaucoma service at Stanford University Hospital.
Last reviewed on December 17, 2019