Mitigating Ocular Surface Disease in Patients With Glaucoma
Learn about the critical need to evaluate glaucoma patients for ocular surface disease and the proactive measures to ensure optimal visual outcomes.
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By
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Zarmeena Vendal, MD
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March 1, 2025
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Clinical Scorecard: Mitigating Ocular Surface Disease in Patients With Glaucoma
At a Glance
| Category | Detail |
|---|
| Condition | Ocular Surface Disease (OSD) in Glaucoma Patients |
| Key Mechanisms | Chronic eyedrop therapy leading to ocular inflammation and destabilization of the tear film. |
| Target Population | Patients with glaucoma, particularly those experiencing symptoms of OSD. |
| Care Setting | Ophthalmology 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.
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