From Drug Choice to Drug Delivery: A Viewpoint on Measuring and Improving Owner Adherence in Canine Corneal Ulcers.

Optimize corneal ulcer outcomes by prioritizing owner adherence through education, frequent rechecks, and simplified dosing schedules.

This viewpoint article addresses a critical gap in veterinary ophthalmology: the role of owner adherence in treating canine corneal ulcers. While antimicrobial selection is important, the author emphasizes that reliable at-home drug delivery is equally crucial for therapeutic success. Drawing evidence from human ophthalmology, the article identifies key factors influencing adherence outcomes: dosing frequency, follow-up intervals, and hands-on technique training. The author proposes a paradigm shift from drug-centered to delivery-centered management strategies. The Clinical Adherence Bundle (CAB-4) comprises four measurable, auditable components: scheduling rechecks within 14 days, minimizing dosing frequency when microbiologically appropriate, providing standardized technique education with written or video support, and preventing medication stockouts. Importantly, all components are designed for practical implementation in routine veterinary practice across both referral and primary-care settings. The article concludes by proposing a prospective research framework to evaluate CAB-4 effectiveness by linking adherence metrics to objective clinical outcomes, including epithelial healing time and corneal perforation rates.

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