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Ophthalmology Management

Article

Mitigating Ocular Surface Disease in Patients With Glaucoma

It is critical that eyecare providers evaluate glaucoma patients for OSD to ensure optimal visual outcomes.

Zarmeena Vendal, MD
Ophthalmology Management March 1, 2025 Vol 30, Issue March 2025 Page(s): 10-11

Clinical Scorecard: Mitigating Ocular Surface Disease in Patients With Glaucoma

At a Glance

CategoryDetail
ConditionOcular Surface Disease (OSD) in Glaucoma Patients
Key MechanismsChronic eyedrop therapy leading to ocular inflammation and destabilization of the tear film.
Target PopulationPatients with glaucoma, particularly those experiencing symptoms of OSD.
Care SettingOphthalmology practices and eye care clinics.

Key Highlights

  • Over 50% of glaucoma patients experience chronic OSD due to eyedrop therapy.
  • Asymptomatic patients may still have corneal staining impacting vision.
  • Non-drop therapies like intracameral implants and laser treatments can reduce OSD.
  • Minimally invasive glaucoma surgery (MIGS) offers a viable option without OSD complications.
  • Preservative-free medications are preferred to mitigate OSD.

Guideline-Based Recommendations

Diagnosis

  • Screen for OSD at the first glaucoma consultation using questionnaires and imaging.

Management

  • Utilize non-topical therapies and preservative-free medications to reduce OSD.

Monitoring & Follow-up

  • Assess tear film, perform corneal staining, and evaluate meibomian gland function regularly.

Risks

  • Chronic use of topical glaucoma medications can exacerbate OSD.

Patient & Prescribing Data

Patients with glaucoma, particularly those with symptoms of OSD or meibomian gland dysfunction.

Use of preservative-free formulations and advanced therapies like CAM and PRP for OSD management.

Clinical Best Practices

  • Perform meibomian gland imaging and assess dry eye symptoms during initial consultations.
  • Consider non-drop therapies such as SLT and MIGS for glaucoma management.
  • Employ CAM and PRP for healing the ocular surface in OSD patients.

References