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Ocular surface and glaucoma, a mutual relationship. Practical suggestions for classification and management.
Michele Figus1, Matteo Sacchi2, Gemma Caterina Rossi3,4
1Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
European Journal of Ophthalmology
|August 31, 2023
Summary
Chronic glaucoma treatments can cause ocular surface disease, impacting medication adherence and surgical outcomes. Stratifying patients by ocular surface health alongside visual field progression is crucial for effective glaucoma management.
Area of Science:
- Ophthalmology
- Ocular Surface Disease
- Glaucoma Management
Background:
- Chronic glaucoma medication use may lead to ocular comorbidities, specifically glaucoma therapy-related ocular surface disease.
- Preservatives and active compounds like prostaglandin analogues in eye drops can cause ocular surface inflammation, affecting tolerability and adherence.
Purpose of the Study:
- To highlight the impact of ocular surface disease in glaucoma patients undergoing chronic treatment.
- To advocate for patient stratification based on both visual field progression and ocular surface disease for strategic management.
- To emphasize the need for early diagnosis, individualized treatment, and safe surgical interventions in glaucoma care.
Main Methods:
- Review of existing literature on glaucoma medications and their effect on the ocular surface.
- Analysis of the relationship between ocular surface inflammation, medication adherence, and surgical outcomes.
- Conceptual framework for patient stratification in glaucoma management.
Main Results:
- Glaucoma medications, including preservatives and prostaglandin analogues, can induce or exacerbate ocular surface inflammation.
- Ocular surface inflammation negatively impacts patient adherence to topical treatments and the success of filtration surgery.
- Current glaucoma management strategies may not adequately account for therapy-related ocular surface disease.
Conclusions:
- A comprehensive glaucoma management strategy requires considering ocular surface health alongside visual field status.
- Precision medicine in glaucoma necessitates individualized treatment plans that address both disease progression and treatment-related side effects.
- Optimizing glaucoma care involves timely diagnosis, tailored medical and surgical interventions, and proactive management of ocular surface disease.
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