PREVALENCE OF OCULAR SURFACE DISEASE IN GLAUCOMA PATIENTS USING ANTI-GLAUCOMA MEDICATONS

AIM; To evaluate the prevalence of ocular surface disorder (OSD) in patients using anti-glaucoma medications METHODS; 150 eyes of 75 glaucoma patients on topical anti-glaucoma medication with preservatives were studied. Patients with history of use of topical corticosteroids, cyclosporine, anti-inflammatory drugs or other topical medications within last 3 months were excluded. Patients completed Ocular Surface Disease Index questionnaire, underwent evaluation by Schirmer test, tear breakup time, corneal and conjunctival lissamine green staining. RESULTS; Mean age of patients was 56.5 (range 23 - 80) years. 50 (67%) patients were males and 25 (33%) patients were females. 56% patients had primary open angle glaucoma. 41% patients had primary angle glaucoma. 3% patients had ocular hypertension. 44 (59%) patients were on single medication. 25 (33%) patients were on two medications. 6 (8%) patients were on three medications. Mean duration of using medication was 3.8 yrs (range; 5 months - 16 yrs). Duration less than 1yrs - 10(13%) patients. 1 to 5 yrs - 36(48%) patients. 5 to 1yrs - 19(26%) patients. More than 10yrs - 10(13%) patients. 32% patients reported symptoms in at least one eye. Severe symptoms were reported by none. Tear breakup time was abnormal in 54.5% patients, severe abnormality in 20.5% patients. Schirmer testing showed 50.5% patients with decreased tear production in at least one eye, severe tear deficiency in 21.5% patients. Lissamine green staining of conjunctival and cornea showed positive results in 47% patients. None had severe staining. As duration of treatment and number of medications increased, more patients became symptomatic and test results became abnormal. CONCLUSION; High prevalence of ocular surface diseases was noted in patients using anti-glaucoma medications, higher the incidence with increasing number of medications and longer duration of usage. Ocular surface disease must be kept in mind in symptomatic patients as it is likely to affect drug compliance