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      Ocular Surface Disease and Glaucoma Medications: A Clinical Approach

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          Abstract

          Ocular surface disease frequently co-exists with glaucoma and may be initiated or exacerbated by topical glaucoma medications. We performed a review of current literature to assess the prevalence, causes, and treatment of ocular surface disease in glaucoma patients, specifically those on topical therapy. A Pubmed database search was conducted. A total of 720 articles published from 1972 to 2018 were found in relation to ocular surface disease, glaucoma, and glaucoma medications. Of these, 102 articles were included in this analysis. We included primary and empirical studies for patients on topical glaucoma medications. Exclusion criteria included case reports, non-English studies, and articles unrelated to the primary subject of this review. Ocular surface disease among normal and glaucomatous eyes was evaluated based on diagnostic testing including clinical exam and questionnaires to determine visual function and quality of life. Glaucoma medications can be associated with toxicities to the ocular surface, most often due to the nature of the preservative included in the medication; however, the incidence of toxicity can be mitigated by the use of preservative free medications, decreased preservative medications, or treatment of dry eye disease. Treatment of glaucoma with laser trabeculoplasty or minimally invasive glaucoma surgeries that spare the conjunctiva and the cornea may avoid or decrease reliance on topical glaucoma medications, potentially avoiding the initiation or progression of ocular surface disease. Recognition and treatment of ocular surface disease in glaucoma patients may improve patient quality of life and medication adherence. This may ultimately improve glaucoma treatment outcomes.

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          Author and article information

          Journal
          Eye & Contact Lens: Science & Clinical Practice
          Ovid Technologies (Wolters Kluwer Health)
          1542-2321
          2019
          January 2019
          : 45
          : 1
          : 11-18
          Article
          10.1097/ICL.0000000000000544
          6298827
          30199425
          7a7937b9-cf74-47eb-99de-e4679bb4518a
          © 2019
          History

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