2020
DOI: 10.1097/apo.0000000000000327
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Understanding the Dual Dilemma of Dry Eye and Glaucoma: An International Review

Abstract: Glaucoma-related ocular surface disease (G-OSD) is a significant, yet often underdiagnosed, ocular co-morbidity affecting 40% to 59% of glaucoma patients worldwide. Although the use of topical glaucoma medications represents a proven strategy to control the untoward effects of high intraocular pressure, this treatment can profoundly disrupt the homeostasis of the tear film. The cumulative effect of medications, preservatives, and excipients alter underlying cellular structures which results in tear film abnorm… Show more

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Cited by 32 publications
(29 citation statements)
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“…Ocular surface toxicity associated with the long-term use of topical anti-glaucoma medication can result from the active ingredient(s), especially for patients with pre-existing OSD, and/or from preservatives and excipients [13][14][15][16][17][18]. Most eye drops contain preservatives, commonly benzalkonium chloride (BAK), which can cause corneal, conjunctival, and trabecular meshwork toxicities resulting in OSD [15][16][17][18][19][20][21].…”
Section: Introductionmentioning
confidence: 99%
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“…Ocular surface toxicity associated with the long-term use of topical anti-glaucoma medication can result from the active ingredient(s), especially for patients with pre-existing OSD, and/or from preservatives and excipients [13][14][15][16][17][18]. Most eye drops contain preservatives, commonly benzalkonium chloride (BAK), which can cause corneal, conjunctival, and trabecular meshwork toxicities resulting in OSD [15][16][17][18][19][20][21].…”
Section: Introductionmentioning
confidence: 99%
“…Ocular surface toxicity associated with the long-term use of topical anti-glaucoma medication can result from the active ingredient(s), especially for patients with pre-existing OSD, and/or from preservatives and excipients [13][14][15][16][17][18]. Most eye drops contain preservatives, commonly benzalkonium chloride (BAK), which can cause corneal, conjunctival, and trabecular meshwork toxicities resulting in OSD [15][16][17][18][19][20][21]. A range of deleterious effects in these tissues has been reported for BAK including apoptosis, oxidative stress, disruption of tight junctions, cytoskeleton changes, and induction of inflammatory chemokines [19,22,23].…”
Section: Introductionmentioning
confidence: 99%
See 1 more Smart Citation
“…Ideally, topical glaucoma treatments, should provide a balance of powerful efficacy alongside an acceptable tolerability profile [ 9 ]. Recent data indicate that treatments that are better tolerated at the ocular surface and result in less OSD may be associated with further reductions in IOP among people with glaucoma, possibly as a result of improved treatment adherence and reduced inflammation at the site of instillation, which allows IOP-lowering medications to act more effectively [ 5 , 7 , 9 14 ]. The European Glaucoma Society (EGS) guidelines emphasize that treatment should consider patient QoL from the outset [ 2 ].…”
Section: Introductionmentioning
confidence: 99%
“…Examples of the side effects of recently approved products are Vyzulta (latanoprostene bunod, 0.024%), which is associated with a permanent pigmentation of the eyelids, lashes and iris [ 6 ]; and Rhopressa (netasudil, 0.02%), which causes conjunctival hyperemia and hemorrhage, eye pain upon instillation and cornea verticillate [ 7 ]. In addition to the previously mentioned side effects, the chronic use of topically applied anti-glaucoma medication may result in a disturbance of the tear film that impacts the health of the patient’s ocular surface and results in a glaucoma-related ocular surface disease and dry eye condition [ 8 ]. Therefore, identification of safe, effective and long-acting drug molecules that can selectively interact with a specific target site inside the eye and have the ability to control the IOP is still an urgent medical need.…”
Section: Introductionmentioning
confidence: 99%