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Rethinking Dry Eye and Ocular Surface Disesase in Glaucoma: Pathophysiology, Diagnosis, and Management
Miriam Kolko1,2,3,4
1Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark.
Journal of Glaucoma
|June 24, 2026
Summary
Ocular surface disease (OSD) significantly impacts glaucoma patients, affecting treatment adherence and visual outcomes. Integrating OSD management into glaucoma care is crucial for improving patient quality of life and treatment success.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Ocular Surface Disease
Background:
- Glaucoma is a leading cause of irreversible blindness globally.
- Treatment adherence is key to managing glaucoma outcomes.
- Ocular surface disease (OSD) is often overlooked in glaucoma patient care.
Purpose of the Study:
- To emphasize the critical role of OSD in glaucoma.
- To examine the links between glaucoma treatments and OSD.
- To propose integrated strategies for enhanced patient care.
Main Methods:
- A narrative review of existing literature was performed.
- Focused on the relationship between glaucoma therapies and ocular surface health.
- Reviewed OSD prevalence, mechanisms, diagnostics, and management in glaucoma patients.
Main Results:
- Topical glaucoma eye drops, especially with BAK, can cause ocular surface toxicity and inflammation.
- OSD affects up to 60% of glaucoma patients, higher than the general population.
- OSD symptoms reduce quality of life and compromise treatment adherence.
Conclusions:
- Ocular surface health is central to glaucoma management, impacting adherence and visual outcomes.
- Preservative-free treatments, surgical options, and patient-centered strategies can protect the ocular surface.
- Integrating OSD management improves long-term quality of life and glaucoma treatment success.
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