For this interview, designed to identify user needs, two distinct but related sets of questions were developed — one for frequent users who struggle with eyedrops and another for healthcare providers who regularly observe patients facing these challenges. The following questions and responses from both groups aim to clarify user needs, demographic insights, and the potential impact of our device in addressing the problem outlined in our needs statement.

Patients/Users

How often and why do you use eye drops?

Interviewee 1: I use them literally 5-10 times a day because of extremely dry eyes due to Sjogren’s syndrome (which is usually something older folks deal with). Harsh lighting at the SMFA and doing lots of work on the computer doesn’t help. 

From experience, what methods work best for you to apply eye drops?

Interviewee 1: I’m not afraid of eye drops and can do it in any way, but the problem for me is losing my eye drops. 

Do you have any issues with using eye drops? What are some of those issues?

Interviewee 1: In addition to losing eye drops, sometimes it’s hard to control how much comes out at a time, and I can use too much. Another thing is aligning it with my eye, where I can put the dropper too close to my eye and it touches my eyeball. Then, I’m worried about getting an infection. 

How do you deal with this problem?

Interviewee 1: Normally, I would just buy more eye drops if I lose too many, but that adds up and isn’t great since they are medicated. After buying a few, I try to keep them in different places like my backpack and my room, but that doesn’t always work. 

Has difficulty using eye drops ever led to you not using them altogether?

Interviewee 1: Yes, if I lose them then I can’t use them until I get home to the ones that I keep in my room, which is really painful.

What do you wish you had at hand (maybe a device?) that could help you with using your eye drops?

Interviewee 1: I wish I had some sort of a tracker that beeps when I am trying to find my eye drops. My grandfather takes a lot of medications but tends to lose them a lot so we have to frequently replace them for him, which is costly. 

If a device could make it easier to apply eye drops, what features would be most important to you?

Interviewee 1: This question doesn’t super apply to what I was thinking, but it could be useful to also have a specific case to carry my eyedrops in so I don’t lose them. Or something else that’s cool is having something like pushing a button so you don’t have to unscrew the cap, which can get crusty. Something else important would be making sure that eyedrops are still portable so I can easily put them in my bag to carry to school or work. Another thing is that I would love it if it’s cute. 

If a theoretical device could make it easier to apply eye drops, would you be willing to spend money to solve this problem?

Interviewee 1: Probably, if I have more disposable income once I graduate, but I could also be convinced now.

If you would be willing to spend money, how much would that amount approximately be?

Interviewee 1: I would be keeping in mind the fact that medicated eye drops are expensive. For something that could help me find eye drops and prevent me from needlessly purchasing more, probably in the range of $50-70 because I would use them everyday and they would be a worthwhile investment. Just a stationary piece or new container for eye drops is less necessary for me, so I’d say around $20.

Healthcare Providers

How often do you prescribe/recommend eye drops?

Interviewee 2: All day long – maybe 20 times a day!

Interviewee 3: Pretty much every day.

What do you prescribe eyedrops for?

Interviewee 2: Glaucoma has many different medications that need to be taken once or twice a day. Other conditions, including dry eyes, is a very common condition that calls for the prescription of eyedrops. There is also uveitis — inflammation of the eye — that needs eyedrops. Pre-surgical and post-surgical patients also need eyedrops — for instance, after cataract surgery, or any other kind of eye surgery. You often need drops, antibiotics, and anti-inflammatory drugs, so eyedrops are used quite a bit in my practice. Nearly half the patients medically use eyedrops. 

What do patients say they struggle with the most when applying eye drops?

Interviewee 2: My patients often tell me that they are struggling with using eyedrops. Most people usually don’t put in eyedrops, so I try to train them how to do it. But, some people have very limited hand movements, or strength in their hands because they are elderly or they have bad arthritis. So, yes it is usually a problem for people to get their eyedrops in. 

Interviewee 3: Yeah, there are lots of people with problems. Some people are healthy, and they still have problems. Other people are elderly, and they have trouble with squeezing the bottle. This is mostly because the bottles are very small the patients can’t get a good enough grip on them to squeeze them.

So how do they fix their problem or what do they currently do?

Interviewee 3: Well, they often don’t get the drops in, so they have to ask for a family member’s help to get drops in, and it ends up inconveniencing family members. Or they can’t use some of the products that are out there, like there are these preservative-free drops to come in small vials, and those are almost out of the question cause they just can’t possibly squeeze the tiny little tube.

What can be the consequences of improper or inconsistent application of the drug/eye drops?

Interviewee 2: For Glaucoma, if [patients] get frustrated and they don’t put their eyedrops in, and their pressure gets high, then they can lose vision from glaucoma. This is because they are not consistent with their eyedrops and their eye pressure is not consistently low. If [patients] don’t take their eyedrops while they have an infection, the infection may not get cured fast enough and can lead to scarring or other problems. Or, if [patients’] eyes are so dry, and they can’t get the eyedrops to alleviate that dryness, then the cornea deteriorates and it can lead to scarring. So, many diseases get much worse if [patients] don’t get their eyedrops in. 

Interviewee 3:  Well, the most common drops are for glaucoma medicines, so they basically miss their glaucoma medicine, and they go blind. Patients also lose their peripheral vision because they’re not treating their glaucoma. And dry eyes are another big one. They can’t see well cause their eyes are so dry and can’t see with a dry cornea. In severe cases, you might get a corneal ulcer as well.

What part of the application of eyedrops do patients struggle with most?

Interviewee 2: Usually, it is to squeeze the bottle or to get the eyedrops in so they don’t waste a lot — honestly, it’s a little bit of both. By the time they are squeezing, [the patients] are wasting half the bottle and these medicines are very expensive, and they don’t know if they’ve got it in their eyes sometimes as well. 

Provide a demographic range of individuals impacted by impaired use of eye drops.

Interviewee 2: I would say, men and women. In my practice, there seem to be more women, but I’m sure there are plenty of men as well — maybe over the age of 75, or even 70 when arthritis in their hands becomes a big problem. 

Interviewee 3: Young people don’t usually have problems with this. They figure it out, so there are two classes: first, the people who just don’t like drops, then the people who are elderly and can’t coordinate putting drops in their eyes.

If a device could make it easier to apply eye drops, what features would you perceive as being most important to help your patients?

Interviewee 2: I think that something that lines the eyedrop bottle up with [the patients’] eyes, so that they don’t have to hold the bottle and hold their eyelids open, would be good. This is so that they don’t have to worry about centering the bottle and applying just enough pressure to it. Essentially, an ideal device would get the eyedrops in the right location, and make it easier to squeeze the bottle. 

Interviewee 3: The device needs to be large enough for the patient to hold comfortably and apply gentle pressure to release a drop. The dropper bottle can’t be too small or rigid; it must be soft and squeezable. Additionally, the medication should be dispensed incrementally—one drop at a time rather than as a squirt. Ideally, the patient should be able to recognize when the drop has successfully entered their eye.

If there was a device that could make it easier to apply eye drops (i.e. assist with squeezing, aligning, and help with dexterity), would you recommend them to patients?

Interviewee 2: You could market the device to eye doctors, and they would recommend it to their patients because it would be a good solution to many problems. I would even just sell it in my office, and show them how to use the device. Then, I could make sure that [the patients] are getting their eyedrops in. 

Interviewee 3: 100% yes. It would improve patients’ lives a lot.

Are there any existing devices you recommend for patients? If so, what are they?

Interviewee 3: Well, there are some devices where you place the bottle inside, and they function like pliers to squeeze it, providing mechanical leverage. However, they’re not always ideal. The bottle doesn’t always fit properly in the device, so it doesn’t consistently work as intended.

If you were to improve these existing devices, what would you recommend they do?

Interviewee 3: I would recommend that drug manufacturers produce larger bottles made from softer materials or establish a standard bottle size. If all bottles were uniform, a simple squeezing device could be designed to work with them. However, since bottle sizes and shapes vary, these assistive devices must adapt to each one, which makes them less effective.

A follow-up question for Interviewee 3: What do you mean by different shapes?

Interviewee 3: Well, some bottles are short and squat, while others are taller. Some are harder to squeeze, and there’s no uniform standard. Even the droppers that dispense the medication vary in shape. As a result, patients sometimes accidentally hit their eyes with the bottle. Another helpful feature would be a device that assists with positioning. Some patients struggle to gauge the correct distance from their eyes. A device that beeps when it’s at the optimal distance could help. For example, if there were a small target light they could align with, and once they reached the right position, the device would beep and automatically release a drop, it would make the process much easier.