Squeeze me if you can: Variability in force requirements to extract a drop from common glaucoma bottles

Daniel B. Moore, Jon D. Hammer, Roozbeh Akhtari, Judy Beck, Sheila Sanders, Richard J. Kryscio

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Purpose: To determine the force requirements to dispense a single drop from commonly prescribed brand and generic topical glaucoma medications and correlate these findings with pinch strength in a representative patient population. Patients and Methods: Four bottles of each medication were tested: 2 in the vertical and 2 in the horizontal orientation. Bottles were housed in a customized force gauge apparatus designed to mimic ballpoint fingertip contact with a bottle tip. For all bottles, each of the first 10 dispensed drops was tested and then tests were performed in increments of 10 until the bottle was empty. For each tested drop, the maximum force and displacement were electronically measured. Concurrently, maximum pinch strength was measured on consecutive glaucoma patients. Results: A total of 84 bottles from 21 bottle designs were tested. There was significant variability across the designs, with roughly a 7-fold (0.67 to 4.49 kgf) and 4-fold (0.81 to 3.00 kgf) difference in force requirements in the vertical and horizontal positions, respectively. Of 53 enrolled patients in the glaucoma clinic, the mean pinch strength was 5.05 (range, 1.23 to 10.4 kgf) and 4.82 (range, 1.47 to 10.67 kgf) kgf for the right and left hands, respectively. Conclusions: There is statistically significant variability in the force required to squeeze a drop from common glaucoma medications, and a representative sampling of clinic patients suggests that many likely struggle with the force requirements of several bottle designs. These data further support standardization of topical glaucoma drug delivery and design.

Original languageEnglish
Pages (from-to)780-784
Number of pages5
JournalJournal of Glaucoma
Issue number9
StatePublished - 2016

Bibliographical note

Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc.


  • Eyedrop
  • Glaucoma medication
  • Pharmacology
  • Pinch strength

ASJC Scopus subject areas

  • Ophthalmology


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