Ocular Surface Changes in Primary Open Angle Glaucoma with Long Term Topical Anti Glaucoma Medication.

Area of Science:

• Ophthalmology
• Ocular Surface Disease

Background:

• Topical anti-glaucoma medications are the primary treatment for primary open-angle glaucoma.
• Long-term use of these medications can lead to significant changes in the conjunctival epithelium.

Purpose of the Study:

• To investigate the ocular surface changes associated with long-term topical anti-glaucoma therapy.
• To evaluate the efficacy of conjunctival impression cytology in monitoring these changes.

Main Methods:

• A study involving 100 primary open-angle glaucoma patients divided into four groups, each receiving a different topical medication (Timolol, Pilocarpine, Brimonidine, Latanoprost).
• Ocular surface health was assessed using Schirmer's test, tear film break-up time (BUT), and conjunctival impression cytology over one year.

Main Results:

• After one year, 40% of patients showed altered Schirmer's test values and 26% had reduced tear film BUT.
• Conjunctival cytology revealed decreased goblet cell density, squamous metaplasia, and inflammatory cells in a significant number of patients.
• A direct correlation was observed between treatment duration and the severity of ocular surface changes, with Timolol showing more pronounced effects.

Conclusions:

• Topical anti-glaucoma therapy can induce significant ocular surface changes in primary open-angle glaucoma patients within one year.
• Conjunctival impression cytology is a valuable, non-invasive method for monitoring these treatment-related ocular surface alterations.