No. Do not use your glaucoma drops more often than prescribed, because extra drops rarely lower pressure further and can cause side effects. If your pressure is still high, see your glaucoma specialist, who can find the cause and change the treatment.
When the pressure report comes back high, the instinct is natural. You think, “I will just add a few more drops.” I hear this question often in clinic. It comes from care, not carelessness.
But glaucoma drops do not work like painkillers. More is not better. A high reading means the treatment plan needs a second look, not a bigger dose.
Why Extra Drops Do Not Lower Pressure Further
- Your eye cannot hold them. A drop is about 30 to 50 microlitres. Your eye holds about 10. The rest runs down your cheek.
- A second drop washes out the first. Extra drops within five minutes push the medicine out before it absorbs.
- Each drug reaches a ceiling. Once the receptors are working, more drug adds little.
- Some drops work less when used more often. Prostaglandin analogues, the most common class, work best once daily. More frequent use can lower pressure less.
- Side effects rise faster than benefit. Beta-blockers can slow the heart and tighten the chest. Preservatives irritate the eye surface.
Why Your Pressure May Still Be High
Your drops may be fine. Something else is often the problem. I check these causes in order.
Technique and Missed Doses
Many patients miss the eye, or the drop leaves too fast. Others skip evening doses without noticing. This is the most common cause I find.
Timing of the Reading
Pressure changes through the day. It often peaks at night, when you are not in clinic. A morning reading can look better than your true pressure. My own work on 24-hour pressure patterns covers this.
The Wrong Drug for Your Eye
Some drops lose effect over time. Your eye may also respond poorly to a class that works well for others.
The Wrong Type of Glaucoma
Drops cannot fix a closed angle. Steroid use and other secondary causes also need different treatment. Here, extra drops waste time.
Understanding What High Eye Pressure on Treatment Means
This means your eye pressure is higher than the target pressure: that is, the pressure at which your optic nerve is safe.
| Situation | Likely Cause | When to Worry |
|---|---|---|
| Pressure high at every visit | Wrong drug, or drops not reaching the eye | Visual field or nerve scan worsens |
| Pressure high only at some visits | Missed doses, or reading at a low point | You skip doses more than twice a week |
| Pressure high with eye pain and headache | Angle closure, or a sudden pressure spike | Same day, see an eye doctor urgently |
| Pressure rose after starting steroids | Steroid response | Tell your doctor before the next dose |
| Pressure normal but vision field worsens | Target too high, or night pressure peaks | Any new field loss on two tests |
Common Mistakes by Patients
Many patients self medicate. They put in two drops instead of one, or put drops more frequently. This doesn’t solve the problem at all. In fact, it often repeats a failed step. The better question is why the pressure is high. I want to see you instil a drop, review your schedule, and check the angle before I change anything.
Please read: Common mistakes glaucoma patients make
What I Do Instead
- I watch you use your drops and fix the technique.
- I review your schedule and the cost or access problems behind missed doses.
- I confirm the reading with repeat measurement at a different time of day.
- I switch to another drug class, or to a fixed combination bottle.
- I discuss laser (SLT), minimally invasive surgery or surgery when drops reach their limit.
More drops sit at the bottom of this list for a reason. Your doctor may prescribe a change in frequency. That is a medical decision. Never make it alone.
What You Can Do Before Your Visit
- Use each drop exactly as prescribed.
- Wait five minutes between different drops.
- Close your eyes for two minutes after each drop.
- Press the inner corner of the eye gently.
- Bring every bottle to your visit, including old ones.
- Write down your dose times for one week.
When to See a Doctor
See a Doctor Urgently
Go to an eye emergency the same day if you have:
- Severe eye pain or a severe headache
- Nausea or vomiting with a red, painful eye
- Halos around lights
- Sudden blurred vision or vision loss
See a Doctor
Book a glaucoma visit within a week or two if you notice:
- Pressure above target at two visits
- New patches or shadows in your vision
- Stinging, redness or heaviness after your drops
- Trouble getting drops into your eye
- New steroid drops, tablets or inhalers from another doctor
What This Means for You
A high reading is a signal to investigate. It does not mean you failed, and it does not mean you need more drops. Most patients improve when we find the real cause. Bring your bottles, your questions and your honest dose record.
Frequently Asked Questions
Can I put in two drops instead of one?
No. Your eye holds about one fifth of a single drop. The second drop spills out and may wash the first one away. It adds side effects without adding benefit.
What if I use my drops at night and my pressure is high in the morning?
This is common. Some drops cover less than 24 hours, and pressure often peaks overnight. Tell your doctor the time of each dose. We may change the drug or the timing.
Can I add a drop from an old prescription?
No. Do not mix old and new drops without asking. Some combinations clash, and some contain the same drug twice. Your doctor can check your full list in minutes.
How do I know if my drops have stopped working?
Your pressure stays above target, or your scans and visual fields worsen. Missed doses and poor technique cause this more often than true drug failure. We check these first.
What are my options if drops cannot control my pressure?
Options include a different drug class, a combination bottle, laser (SLT), minimally invasive glaucoma surgery or conventional surgery. The right choice depends on your glaucoma type and stage.
Is Your Pressure Still High Despite Your Drops?
Bring your bottles, your reports and your dose record. At my clinic in Gurgaon, I will find out why your pressure is high and what to change. Book a glaucoma consultation or upload your reports.
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This page is part of the Glaucoma Eye Drops hub. Read about our full approach to glaucoma care. This article is part of a series of articles on Using Eyedrops, which aim to help you use your eye drops as required. You may want to read How to remember your glaucoma medication, Tips and tricks on how to use your eye drops, Whether refrigerating eye drops helps, How to manage side effects of glaucoma drops, Why my dry eye drops are not working, How to reduce glaucoma drops, Glaucoma drops not working, Should I Switch to Preservative Free Eye Drops for Glaucoma and Glaucoma progressing despite eye drops.
You may also want to learn how to put eyedrops here.
About the Author
This article was written by Dr Shibal Bhartiya, fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator, Clinical Director at Marengo Asia Hospitals, Gurugram, known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. She is also the Program Director for Community Outreach & Wellness; and for the Marengo Asia International Institute of Neuro and Spine.
Dr Bhartiya has published peer-reviewed research onglaucoma management, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes. She is also a committed patient advocate and mainstream medical columnist, translating complex ophthalmic evidence into actionable public health insights across leading national platforms including NDTV and OnlyMyHealth
Dr Bhartiya is the Editor-in-Chief of Clinical and Experimental Vision and Eye Research and Executive Editor of the Journal of Current Glaucoma Practice (Pubmed Indexed, official journal of the International Society of Glaucoma Surgery). Her 200+ publications, including 90+ PubMed-indexed publications and 28 edited textbooks span glaucoma biology, surgical outcomes, health equity, and emerging diagnostics.
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Last Reviewed: November 2026