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Ocular Surface Disease

Expert consensus delivers recommendations for managing ocular surface inflammation in glaucoma patients

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The development of 24 consensus-based clinical recommendations aimed at improving the management of ocular surface inflammation (OSI) in patients with glaucoma emphasized the importance of early detection, preventive measures such as minimizing preserved medications, and tailored treatment strategies based on the severity of OSI and ocular surface disease (OSD).

Led by a steering committee comprising experts in the fields of glaucoma and ocular surface disease, the consensus-building process employed a rigorous quasi-Delphi methodology, involving an analysis of current literature to identify gaps in existing practices, followed by a web-based interactive survey among Educational Club of Ocular Surface and Glaucoma (ECOS-G) faculty members.

The consensus underscored the importance of investigating OSI in all glaucoma patients, emphasizing early intervention as pivotal to mitigating long-term complications.

Key preventive measures highlighted the reduction or elimination of preserved medications, particularly those containing benzalkonium chloride (BAK), known for its adverse effects on the ocular surface. Furthermore, a nuanced treatment approach was recommended, wherein interventions are tailored subtractively based on the severity of OSI/OSD, with consideration given prior to undertaking glaucoma surgery.

The steering committee reported robust consensus rates, with between 80% to 100% agreement among faculty members on the finalized recommendations.

Reference
Messmer EM, Baudouin C, Benitez-Del-Castillo JM, et al. Expert Consensus Recommendations for the Management of Ocular Surface Inflammation in Patients with Glaucoma. J Glaucoma. 2024 Jul 18. doi: 10.1097/IJG.0000000000002465. Epub ahead of print. PMID: 39018018.

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