Abstract
Aim: To compare the prevalence of ocular surface disease (OSD) in patients using antiglaucoma medications vs normal subjects.
 Design: Prospective observational study.
 Methods: A total of 94 patients with glaucoma on topical medications were included in the study group. Age- and gender-matched normal subjects (n = 94) formed the control group. They were assessed for OSD using ocular surface disease index (OSDI) questionnaire, tear break-up time (TBUT), Lissamine green staining, and Schirmer’s test.
 Results: The prevalence of OSD was significantly more in the study group (72.4%) when compared to controls (44.6%) using the OSDI questionnaire. Schirmer’s test showed 84% patients had decreased tear production in the study group vs 53% in controls. TBUT was abnormal in 67.1% of the study group and of 47.8% controls. Lissamine green staining was positive in 36.2% of patients in the study group and 31.8% of controls.
 Conclusion: OSD was more common in patients using intraocular pressure (IOP)-lowering drugs than in controls. Long-term therapy and multiple medications were associated with severe OSD.
Highlights
Topical hypotensive medications remain the standard form of therapy for glaucoma
Glaucoma patients have to be treated with topical medications that contain preservatives and cause increased tear evaporation, inducing an immunological and/or toxic response from the ocular surface.[4]
Dry eye disease is of two types: aqueous tear-deficient dry eye (ADDE) and evaporative dry eye (EDE)
Summary
Topical hypotensive medications remain the standard form of therapy for glaucoma. Intraocular pressure (IOP)-lowering medications are multidose medications and include preservatives to prevent microbial contamination and biodegradation, maintaining drug potency and prolonging its shelf life.[1,2]As glaucoma is a disease of the elderly, they are more prone to developing ocular surface disease (OSD). Topical hypotensive medications remain the standard form of therapy for glaucoma. Intraocular pressure (IOP)-lowering medications are multidose medications and include preservatives to prevent microbial contamination and biodegradation, maintaining drug potency and prolonging its shelf life.[1,2]. As glaucoma is a disease of the elderly, they are more prone to developing ocular surface disease (OSD). Prevalence of OSD in people over 40 years is 2.1%, ranging from 0.3% in people aged 40 years to 3.3% in people aged 70 years.[3] Glaucoma patients have to be treated with topical medications that contain preservatives and cause increased tear evaporation, inducing an immunological and/or toxic response from the ocular surface.[4]. OSD in patients with glaucoma on topical medications
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