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Double Whammy: Are your glaucoma medications causing you dry eyes?

According to the Dry Eye Workshop report, dry eye syndrome is a multifactorial disorder of the tear film and ocular surface. The presenting symptoms ranges from visual disturbances, eye discomfort, pain to clinical signs of tear film inconsistency, possible ocular surface alterations and anormal lids findings. Dry eye syndrome is currently on the rise, with the technological and environmental changes in our society such as air pollution, increased hours of screen time, DES is becoming one of the most presenting complaints in the ophthalmic setting.  All these impact on the quality of life negatively.  Aside the symptoms which can be described as quite painful and irritation, sufferers of dry eyes are most likely to avoid or limit their time spent reading or working on their computers. Also, the need to constantly instill lubricants in the eyes could be very tasking.

Presentation of DES and glaucoma in a patient is already challenging to manage. Antiglaucoma drops can exacerbate dry eyes syndrome in patients with the condition and can alter the ocular surface in otherwise patients without dry eyes.  These pathological changes potentially have a negative effect on the patient’s compliance with the prescribed glaucoma medical therapy.

Glaucoma affects millions of patients around the world and the management of this condition is mostly with medical therapy. Glaucoma medications often affects the patient’s ocular surface and vision negatively by disrupting the homeostasis of the tear film. The chronicity of glaucoma requires a long-term use of these medications in dire quest to reduce and maintain the intraocular pressure. The accumulated effects of these medications and its preservatives will subsequently alter the ocular surface structure resulting in tear film abnormalities and instability.

Glaucoma related ocular surface disease (G-OSD) is a prevalent multifaceted ocular co-mobility affecting 40-50% of glaucoma patients worldwide.1 In Australia about 39% of patients with glaucoma suffered from dry eyes and the economic burden is about AUD330.5 million per year .1The co-existence of glaucoma and dry eyes both results in high prevalence of anxiety and depression.2,3The prevalence of these 2 significant ocular co-morbidities is huge and requires early detection and proper management as it will thus have an impact on patient’s compliance with their glaucoma medication management.4,5

Are you using glaucoma medication? Are you experiencing dry eye symptoms? Does your glaucoma medication give you eye irritation? Our Canberra Optometrists at Junic Eyecare Plus Coombs located at Molonglo Health Hub Coombs are sure to look after you!

Book in for your glaucoma and dry eyes assessment at www.juniceyecare.com.au or call us on (02) 6152 8585.

REFERENCES

  1. Chan CC, Crowston JG, Tan R, Marin M, Charles S. Burden of Ocular Surface Disease in Patients with Glaucoma from Australia. Asia Pac J Ophthalmol (Phila). 2013 Mar-Apr;2(2):79-87. doi: 10.1097/APO.0b013e31828372c2. PMID: 26108043.
  2. Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006; 90(3):262–267. [PubMed: 16488940]
  3. Servat JJ, Bernardino CR. Effects of common topical antiglaucoma medications on the ocular surface, eyelids and periorbital tissue. Drugs Aging. 2011; 28(4):267–282. DOI: 10.2165/11588830-000000000-00000 [PubMed: 21428462]
  4.  Fechtner RD, Godfrey DG, Budenz D, Stewart JA, Stewart WC, Jasek MC. Prevalence of ocular surface complaints in patients with glaucoma using topical intraocular pressure-lowering medications. Cornea. 2010; 29(6):618–621. DOI: 10.1097/ICO.0b013e3181c325b2 [PubMed: 20386433]
  5. Russ HH, Nogueira-Filho PA, de Barros JN, et al. Ocular surface evaluation in patients treated with a fixed combination of prostaglandin analogues with 0.5% timolol maleate topical monotherapy: A randomized clinical trial. Clinics (Sao Paulo). 2013; 68(10):1318–1324. DOI: 10.6061/clinics/ 2013(10)05 [PubMed: 24212838]

For more information, contact us on (02) 6152 8585 or book online https://juniceyecare.com.au/.

Author: Juliet Menakaya, O.D MPH

CANBERRA OPTOMETRIST Juliet obtained her Doctor of Optometry degree from the University of Benin, Nigeria in 2006. She completed an internship programme before migrating to Australia, where she completed a master’s degree in public health at the University of Sydney in 2014. Following this, Juliet obtained a Master of Orthoptics from the University of Technology Sydney (UTS) in 2017. Juliet has completed her competency in optometry examination with OCANZ (Optometry Council of Australia and New Zealand), and obtained her ophthalmic prescribing rights from ACO (Australian College Of Optometry Victoria). Juliet has worked in various positions, including retail Optometry, the Ophthalmology Department at Canberra Hospital, and more recently, at the John Curtin School of Medical Research (ANU). As a dedicated Canberra optometrist, Juliet is passionate about helping people with low vision, and binocular vision anomalies hence her interests in Low Vision Rehabilitation, Eccentric Viewing Training and Paediatric optometry.