The Science behind the Tip
The prevalence of ocular surface disease is significantly higher in glaucoma patients (1). While generally accepted that preserved topical antiglaucoma medication can have significant side effects, preservative-free medication may also be associated with ocular surface disease. Betablockers, prostaglandin analogues, carbonic anhydrase inhibitors and pilocarpine are all shown to potentially cause an exacerbation of ocular surface disease (2, 3, 4).
In dry eye, changes in the subbasal corneal nerve plexus can result in decreased corneal sensitivity, which can mask subjective symptoms of ocular surface disease, thus feigning good tolerance of the topical therapy (5).
Therefore, it is recommended to not only ask the patient for symptoms, but to specifically check for signs of ocular surface disease.
Contributor: Cornelia Hirn, Vienna, Austria
References
Tip Reviewer: Roger Hitchings
Tip Editors: Frances Meier-Gibbons, Humma Shahid, Karl Mercieca, Francisco Goni