Purpose This study aimed to investigate (1) the prevalence of nonadherence with eye drop treatment; (2) selected correlates of nonadherence at the patient and health-care organization level; and (3) the diagnostic value of the ophthalmologists' ratings, using patients' self-reports as standard. Methods This cross-sectional multicenter survey used questionnaires for ophthalmologists and their patients to assess self-reported nonadherence and its correlates. One item, using a 4-point scale [never (ie, adherent) to daily], asked the patients whether they had forgotten to administer eye drops during the past 2 weeks. Ophthalmologists rated their patients as adherent or nonadherent. Nonadherence was also determined by combined methods, whereby either could indicate nonadherence. Given the nested structure of the data, multilevel modeling was used to investigate self-reported nonadherence-correlates. Diagnostic values of ophthalmologists' report were calculated. Results Of 663 patients (48% female, 44% >69 years), nonadherence was indicated in 39.2% (n=260) through self-reporting, 2.1% (n=14) through ophthalmologists' ratings, and 40% (n=266) through combined measures. The multivariable, multilevel model showed following significant nonadherence-correlates: Male sex (P=0.01), younger age (P=0.027), and higher-dose frequency (P=0.001). No significant correlation with treating ophthalmologist (P=0.21) could be seen. Yet, the patients visiting their ophthalmologists at least every 3 months were less nonadherent than patients with fewer consultations (P=0.01). The ophthalmologists' report showed a sensitivity and specificity of 3% and 98.5%, respectively. Conclusions The prevalence of self-reported nonadherence was congruent with literature. The patients visiting their ophthalmologists at least every 3 months have a lower risk of nonadherence. Ophthalmologist report is an insensitive method for detecting nonadherence.

Purpose: This study aimed to investigate (1) the prevalence of nonadherence with eye drop treatment; (2) selected correlates of nonadherence at the patient and health-care organization level; and (3) the diagnostic value of the ophthalmologists' ratings, using patients' self-reports as standard.Methods: This cross-sectional multicenter survey used questionnaires for ophthalmologists and their patients to assess self-reported nonadherence and its correlates. One item, using a 4-point scale [never (ie, adherent) to daily], asked the patients whether they had forgotten to administer eye drops during the past 2 weeks. Ophthalmologists rated their patients as adherent or nonadherent. Nonadherence was also determined by combined methods, whereby either could indicate nonadherence. Given the nested structure of the data, multilevel modeling was used to investigate self-reported nonadherence-correlates. Diagnostic values of ophthalmologists' report were calculated.Results: Of 663 patients (48% female, 44% >69 years), nonadherence was indicated in 39.2% (n=260) through self-reporting, 2.1% (n=14) through ophthalmologists' ratings, and 40% (n= 266) through combined measures. The multivariable, multilevel model showed following significant nonadherence-correlates: Male sex (P=0.01), younger age (P=0.027), and higher-dose frequency (P=0.001). No significant correlation with treating ophthalmologist (P=0.21) could be seen. Yet, the patients visiting their ophthalmologists at least every 3 months were less nonadherent than patients with fewer consultations (P=0.01). The ophthalmologists' report showed a sensitivity and specificity of 3% and 98.5%, respectively.Conclusions: The prevalence of self-reported nonadherence was congruent with literature. The patients visiting their ophthalmologists at least every 3 months have a lower risk of nonadherence. Ophthalmologist report is an insensitive method for detecting nonadherence.

In a prospective descriptive laboratory study, 25 Helping Hand™ (HH) (10 without and 15 with reminder system) and 50 Medication Event Monitoring Systems (MEMS) (25 with 18-month and 25 with 2-year battery life) were manipulated twice daily following a predefined protocol during 3 consecutive weeks. Accuracy was determined using the fixed manipulation scheme as the reference. Perfect functioning (i.e., total absence of missing registrations and/or overregistrations) was observed in 70% of the HH without, 87% of the HH with reminder, 20% MEMS with 18 months, and 100% with 2-year battery life respectively.

The aim of this study was to compare the intra-ocular pressure (IOP) obtained by ocular response analyzer (ORA), dynamic contour tonometer (DCT) and Goldmann applanation tonometer (GAT). In 102 patients (47 with primary open-angle glaucoma and 55 healthy controls) IOP was measured with GAT, ORA and DCT in one eye. The agreement between GAT, DCT and ORA values was assessed using Bland–Altman plots. The discrepancy between the methods was related to central corneal thickness (CCT), corneal hysteresis (CH) and corneal resistance factor (CRF) using linear regression models. Significant differences were observed amongst DCT, corneal compensated ORA (ORAcc) and GAT (P < 0.01). Only the ORAcc and DCT were comparable. ORAcc and DCT significantly over-estimated IOP compared to GAT and for ORAcc this difference depended on the height of IOP. A significant correlation was found between CCT and the deviation of DCT and ORAcc from corrected GAT (both P < 0.0001). Our study showed a low degree of agreement between IOP measured by ORA, DCT and GAT. DCT and ORAcc over-estimated the IOP compared to GAT.

Purpose: To compare the intraocular pressure (IOP) readings taken with the ICare tonometer, the Pascal Dynamic Contour Tonometer (DCT), and the Ocular Response Analyzer (ORA) with the Goldmann Applanation Tonometer (GAT). To evaluate the influence of central corneal thickness (CCT) on the IOP measurements. Methods: In a prospective study 93 eyes of 93 patients attending the glaucoma clinic were examined. Patients were randomly divided into four groups to vary the order in which the tonometers were applied. CCT was measured with an ultrasound pachymeter (Pachmate). A multivariate normal model was used to compare the mean IOP measurements between the four instruments. Spearman correlation coefficients were used to assess the correlation between IOP measurements and CCT. Bland-Altman plots were used to assess the agreement between the tonometry methods. Results: The average CCT was 558 ±47.4 μm. The mean IOP for GAT, ICare, DCT, and ORA (Goldmann correlated IOP) were 15.1 ±4.8, 15.7 ±5.7, 18.3 ±5.1, and 18.3 ±6.6 mmHg respectively. There was no significant difference between the mean IOP obtained with GAT and ICare (p=0.44), nor between DCT and ORA (p=0.99). There was no correlation between the IOP measurements and CCT for the four instruments. Bland-Altman graphs show disagreement between the measurements taken by the four tonometers. Conclusions: IOP readings from ICare are in accordance with those from GAT, whereas DCT readings correspond well to (Goldmann correlated) ORA measurements. DCT and ORA readings both overestimate IOP measured with GAT.