Ocular surface disease (OSD), a disorder affecting the lacrimal and meibomian glands and the corneal and conjunctival epithelium, is a well-known complication of topical glaucoma therapy. OSD can present as a new or pre-existing condition that virtually any anti-glaucoma formulation can exacerbate. As such, both glaucoma and OSD frequently coexist. Typical OSD symptoms include ocular discomfort, redness, burning, and dryness, whereas signs include periorbital and eyelid skin pigmentation, conjunctival scarring, and superficial punctate keratitis. Pressure-lowering eyedrops can cause toxic, allergic, and inflammatory reactions on the ocular surface. The latter can result from either preservatives or direct toxicity from the active molecule. Although usually mild, OSD can cause significant symptoms that lead to poor quality of life, decreased compliance to therapy, glaucoma progression, and worse visual outcomes. Given the chronic nature of glaucoma, lack of curative therapy, and subsequent lifelong treatment, addressing OSD is necessary. This manuscript aims to provide an up-to-date overview of OSD’s signs, symptoms, and pathogenic mechanisms from glaucoma therapy toxicity.

Students that enroll in a vocational orientation program develop an early interest in the profession. Their involvement generates a higher sense of personal wellbeing, as well as positive academic and professional outcomes. A program was developed for high school students to experience first-hand what it means to work on health sciences. Two years after, the effects of the vocational program were assessed to analyze students' motivation and satisfaction with their professional orientation.

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Background/purpose Identify the prevalence and risk factors for secondary glaucoma among Mexican-mestizo patients with Vogt-Koyanagi-Harada Disease (VKH). Methods Retrospective cohort study analyzing the demographic, clinical, and epidemiological variables. Risk estimates were calculated using a Cox proportional hazards regression model. Results One hundred eyes of 50 patients, 44 (88%) women and 6 men (12%) with a median age of 35.5 years (IQR 29–46) and a median follow-up time of 72 months (IQR 13.7–126.7) were analyzed. The prevalence of glaucoma was 20%, with angle-closure accounting for 70% of all cases. Significant clinical risk factors for glaucoma development were a chronic recurrent stage at presentation (RR 2.88, 95% CI 1.11–12.63, p = 0.037), ≥ 2 episodes of recurrent anterior uveitis (RR 8.52, 95% CI 2.02–35.92, p < 0.001), angle-closure disease (ACD, RR 7.08, 95% CI 2.44–20.48, p < 0.001), iris bombé (RR 5.0, 95% CI 2.10–11.90, p < 0.001), and peripapillary atrophy (RR 3.56, 95% CI 1.43–8.85, p < 0.001). Exposure to > 24 months of oral (RR 9.33, 95% CI 2.21–39.28, p < 0.001) or > 12 months of topical corticosteroids (RR 3.88, 95% CI 1.31–11.46, p = 0.007) were associated with an increased likelihood for secondary glaucoma development. Conclusion Glaucoma is a frequent complication of VKH, often attributed to mixed pathogenic mechanisms. Chronic disease at presentation, recurrent inflammation, angle-closure mechanisms, iris bombé, and peripapillary atrophy represent clinically significant risk factors for developing secondary glaucoma. Prompt and aggressive steroid-spearing immunosuppressive therapy for adequate inflammation control may lower the risk of glaucoma in VKH.