Free Eye Drop Schedule Template
Eye Drop Schedule
|
Time |
Medication |
Eye(s) |
Drops |
|---|---|---|---|
|
8:00 AM |
Latanoprost |
Both |
1 |
|
12:00 PM |
Brimonidine |
Both |
1 |
|
4:00 PM |
Timolol |
Both |
1 |
|
8:00 PM |
Dorzolamide |
Both |
1 |
Notes:
-
Wash hands before administering eye drops.
-
Tilt head back, look up, and pull down the lower eyelid to create a pouch.
-
Squeeze the prescribed number of drops into the pouch, then close the eye for 1-2 minutes.
-
Wait at least 5 minutes between different eye drop medications.
