To study the ocular surface disease in patients being treated with topical antiglaucoma medication. And also study the relationship between the OSD and topical antiglaucoma medication.
Methodology: It was a A prospective study, carried out during the year from November 2019 to October 2020 Patients of age group 30 - 50 years who are diagnosed with glaucoma and started on topical antiglaucoma medication at glaucoma unit in Sarojini Devi eye Hospital, Hyderabad. Before starting topical antiglaucoma medication Patient is evaluated by measuring tear film break-up time, fluorescein staining of cornea, schirmer test and impression cytology. After starting topical antiglaucoma medication, the patient is evaluated again at 1 month, 3 months, 6 months and 1 year for any ocular surface changes or at any time if the patient develops symptoms of OSD.
Results: A total of 100 patients with glaucoma were included in the study, among them 56% were males and 44% were females. Mean age of the patients is 43.8 years, ranging from 37 to 50 years. Of the 100 patients, 21patients had primary open angle glaucoma, 60 patients had primary angle closure glaucoma, 19 patients had combined mechanism glaucoma. TBUT was significantly reduced in 60% patients, Schirmer’s test showed that 84% patients had reduced tear production and 28% patients showed positive fluorescein staining. The prevalence of OSD among users of preserved topical antiglaucoma medications was significantly higher than among nonusers as assessed by FTBUT (83.5% vs. 57.3%; P<0.001), Schirmer I (30.1% vs. 17.5%; P = 0.033), and ocular surface staining (62.1% vs. 31.1%; P<0.001).
Conclusion: In this study we observed a serious impact on the tear function tests and low grade metaplasia in majority of the patients almost 84% at the end of 12 months of treatment and the impact was directly related to the number of medications used. Finally, OSD can influence treatment adherence and prognosis, thus greatly influencing the quality of the life of glaucoma patients. Further studies are needed to validate the effects of BAK and BAK- free agents on OSD. The quality of these glaucoma patients can be improved by switching over to medications with a smaller percentage of BAK or BAK - free.