Optimizing topical drop efficacy with proper eyelid positioning
Purpose: To report the observation that the efficacy of topical glaucoma treatment improved after surgical correction of ectropion in a 71-year-old male with a known history of glaucoma. Observations: The patient initially presented for tearing and lid malposition and was found to have bilateral ele...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S245199362400121X |
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| author | Yu Xia Nathaniel A. Blecher Philip L. Custer Erin G. Sieck |
| author_facet | Yu Xia Nathaniel A. Blecher Philip L. Custer Erin G. Sieck |
| author_sort | Yu Xia |
| collection | DOAJ |
| description | Purpose: To report the observation that the efficacy of topical glaucoma treatment improved after surgical correction of ectropion in a 71-year-old male with a known history of glaucoma. Observations: The patient initially presented for tearing and lid malposition and was found to have bilateral elevated intraocular pressures (IOP) in addition to bilateral lower eyelid ectropion. IOP control was initially prioritized over ectropion repair, with IOP remaining elevated despite topical glaucoma treatment and selective laser trabeculoplasty. Sequential unilateral ectropion repair was then carried out, with topical glaucoma treatment resumed after the first repair. It was observed that the IOP improved with topical glaucoma treatment on each side after ectropion repair, despite no changes to medications nor dosing. Conclusions and importance: The efficacy of topical glaucoma treatment is dependent on drop availability and absorption. While recent efforts to increase drop efficacy have been focused on engineering formulations that increase retention or corneal penetration, our case highlights that in selected glaucoma patients, correction of lid malposition may serve as an effective way to improve drop efficacy. |
| format | Article |
| id | doaj-art-9a8c6c20ab764a7c88e87e65da1c4d44 |
| institution | Kabale University |
| issn | 2451-9936 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj-art-9a8c6c20ab764a7c88e87e65da1c4d442024-12-18T08:50:25ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-12-0136102111Optimizing topical drop efficacy with proper eyelid positioningYu Xia0Nathaniel A. Blecher1Philip L. Custer2Erin G. Sieck3Medical Scientist Training Program, Washington University School of Medicine, St. Louis, MO, 63110, USADepartment of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, 63110, USADepartment of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, 63110, USADepartment of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, 63110, USA; Corresponding author.Purpose: To report the observation that the efficacy of topical glaucoma treatment improved after surgical correction of ectropion in a 71-year-old male with a known history of glaucoma. Observations: The patient initially presented for tearing and lid malposition and was found to have bilateral elevated intraocular pressures (IOP) in addition to bilateral lower eyelid ectropion. IOP control was initially prioritized over ectropion repair, with IOP remaining elevated despite topical glaucoma treatment and selective laser trabeculoplasty. Sequential unilateral ectropion repair was then carried out, with topical glaucoma treatment resumed after the first repair. It was observed that the IOP improved with topical glaucoma treatment on each side after ectropion repair, despite no changes to medications nor dosing. Conclusions and importance: The efficacy of topical glaucoma treatment is dependent on drop availability and absorption. While recent efforts to increase drop efficacy have been focused on engineering formulations that increase retention or corneal penetration, our case highlights that in selected glaucoma patients, correction of lid malposition may serve as an effective way to improve drop efficacy.http://www.sciencedirect.com/science/article/pii/S245199362400121XEyelid positioningEctropionTopical drop efficacyGlaucoma management |
| spellingShingle | Yu Xia Nathaniel A. Blecher Philip L. Custer Erin G. Sieck Optimizing topical drop efficacy with proper eyelid positioning American Journal of Ophthalmology Case Reports Eyelid positioning Ectropion Topical drop efficacy Glaucoma management |
| title | Optimizing topical drop efficacy with proper eyelid positioning |
| title_full | Optimizing topical drop efficacy with proper eyelid positioning |
| title_fullStr | Optimizing topical drop efficacy with proper eyelid positioning |
| title_full_unstemmed | Optimizing topical drop efficacy with proper eyelid positioning |
| title_short | Optimizing topical drop efficacy with proper eyelid positioning |
| title_sort | optimizing topical drop efficacy with proper eyelid positioning |
| topic | Eyelid positioning Ectropion Topical drop efficacy Glaucoma management |
| url | http://www.sciencedirect.com/science/article/pii/S245199362400121X |
| work_keys_str_mv | AT yuxia optimizingtopicaldropefficacywithpropereyelidpositioning AT nathanielablecher optimizingtopicaldropefficacywithpropereyelidpositioning AT philiplcuster optimizingtopicaldropefficacywithpropereyelidpositioning AT eringsieck optimizingtopicaldropefficacywithpropereyelidpositioning |