Ocular Surface Disease in Patients with Glaucoma

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Ocular surface disease

Ocular surface disease represents a spectrum of disorders that affect the surface of the eyes. Dry eye syndrome is one of the most common ocular surface diseases, with incidence ranging from 5.7% to 21.6%.[1][2][3][4] Symptoms of dry eye and ocular surface disease include sensation of dryness, redness, tearing, irritation, burning, foreign body sensation, light sensitivity and intermittent blurred vision. Questionnaires and surveys such as the Ocular Surface Disease Index (OSDI) and Symptom Assessment iN Dry Eye (SANDE) represent methods of characterizing associated symptoms in a systematic manner.[5][6]


With a prevalence of 3.54%, glaucoma is one of the leading causes of blindness worldwide.[7][8] Symptoms from primary open-angle glaucoma (POAG) generally only arrive when the disease is well advanced portending the importance of screening eye exams and diagnosis in early phases of the disease. The typical signs are related to secondary effects of the optic neuropathy on anatomy of the eye and functional performance with visual field testing. However, given that the most common first line of therapy of glaucoma is topical therapy, development of symptoms from the treatment itself is possibly more prevalent and described below.

Ocular surface disease in patients with glaucoma

Both ocular surface disease and glaucoma are more common in older, and first-line therapy for these disease entities are topical medications.[9] They are both spectrum of disease and severity but when coexistent can compound each other. This interaction is further complicated by treatments for each condition which can interact and yield counterproductive effects (Figure 1).