Preserving ocular surface health should be considered a key component of glaucoma care, with patient-centered and preservative-sparing strategies potentially helping to improve treatment adherence, quality of life, and long-term outcomes, according to a recent review.
The review found that ocular surface disease (OSD) affects up to 60% of patients with glaucoma, which is substantially higher than in the general population. Chronic use of topical intraocular pressure-lowering medications, particularly those containing benzalkonium chloride (BAK), was associated with epithelial and goblet cell toxicity, tear film instability, and ocular inflammation.
Symptoms of OSD, including dryness, burning, and blurred vision, can negatively impact patients’ quality of life and may reduce adherence to glaucoma treatment, according to the review. The authors emphasized the importance of recognizing and addressing ocular surface complications.
The review highlighted several approaches to reducing ocular surface burden, including the use of preservative-free medications, selective laser trabeculoplasty, and minimally invasive glaucoma surgery. The authors also noted that structured assessments using questionnaires, slit-lamp examination, and diagnostic testing can support earlier detection and individualized management of OSD.
Reference
Kolko M. Rethinking Dry Eye and Ocular Surface Disease in Glaucoma: Pathophysiology, Diagnosis, and Management. J Glaucoma. 2026;35(7):455-463. doi: 10.1097/IJG.0000000000002729. Epub 2026 May 6. PMID: 42340748.
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