A descriptive study on ocular surface disease in patients with primary open-angle glaucoma on long-term treatment with topical antiglaucoma drugs
Jain George, Gigi Augustine Thottappilly, Thresika Uvaraj, Lathika Vasu KamaladeviABSTRACT
Purpose:
This study aims to evaluate the prevalence of ocular surface disease (OSD) in patients receiving topical antiglaucoma therapy and to examine its association with the number of medications, duration of treatment, and exposure to benzalkonium chloride (BAK). The findings may support improved clinical decision-making, and help mitigate ocular surface complications in glaucoma management.
Methods:
This prospective observational study was conducted over 18 months in a tertiary care center and included patients with primary open-angle glaucoma (POAG) on topical therapy for at least 6 months. OSD was assessed using the ocular surface disease index (OSDI) questionnaire and clinical tests including Schirmer’s test, tear film break-up time (TBUT), and ocular surface staining. Patients were categorized based on the number, duration, and preservative content of antiglaucoma medications. Statistical analysis was performed using Statistical package for social sciences version 23 licenced by Amala Institute of Medical Sciences, Thrissur, Kerala, India, with significance set at P < 0.05.
Results:
The prevalence of OSD in the study cohort was 86.4%. The severity of OSD increased with the number of drugs and the duration of treatment. The distribution of OSD was 76.3% in patients using one drug, 100% in those using two drugs, and 100% in those using three drugs. OSD was most prevalent among patients using beta-blockers (100%), followed by alpha agonists (93.7%), and prostaglandin analogues (46.8%). Subjective evaluation using the OSDI questionnaire indicated that 54.5% of patients experienced significant symptoms of OSD. No significant correlation was found between OSD and patient age, gender, presence of preservatives, or diabetes mellitus status.
Conclusion:
OSD is highly prevalent among POAG patients on long-term topical antiglaucoma therapy. The number and duration of drug usage significantly impact the severity of OSD. Preventive measures and treatment strategies should be considered to improve patient compliance and overall quality of life.