Dry Eye’S Treatment Can Significantly Improve Reliability And Visual Field Index Of Glaucoma Patients.

One of the functions of a precorneal tear film layer is to provide a smooth optical surface, which is essential for the maintenance of high-quality retinal images and vision. Any deterioration of the tear film may cause an irregular surface of cornea and a decrease in visual acuity and contrast sensitivity that might deteriorate the Visual Field test (VF), the mainstream for assessment of functional glaucomatous loss and progressive damage.

Therefore, it is important to diagnose and treat dry eye to assess glaucoma functional loss and to improve adherence and success rate of glaucoma therapy.

Sixty eyes of 30 patients with medically treated primary open-angle glaucoma were included in this study. A diagnosis of POAG was established when characteristic glaucomatous optic nerve head changes (rim thinning, excavation, and/or retinal nerve fiber layer defects) and VF defects, were detected on 2 consecutive tests and open drainage angles by gonioscopy.

Dry eye syndrome was searched with Schirmer test (less than 10 mm in 5 minutes) and tear break-up time (BUT: less than 10 seconds).

Forty-eight eyes medically treated primary open-angle glaucoma (80%) present dry eye syndrome which was graded on the basis of severity.

To treat the ocular surface disease, we used preservative free artificial tears and we saved the same glaucoma eye drops.

After solving the dry eye syndrome, we affect a control of Visual Field test. No differences could be found in pattern standard deviation (PSD) values, fixation losses, false-positive errors, and false-negative errors after the treatment, whereas there were significant improvements in test duration and mean

deviation (MD).

So, we can say that dry eye’s treatment can significantly improve reliability and visual field index of glaucoma patients undergoing visual field test.

Healthy, regular corneal surface is an important requirement for patients who need to perform VF examinations, which, in turn, influence glaucoma treatment decisions.

Previous studies have shown that VF test parameters are adversely influenced by corneal surface irregularities such as those detected in the setting of dry eye, and that artificial tears reduce the symptoms of foreign body sensation and improve visual quality by establishing a regular, optically superior corneal surface.

So, it is recommended that patients with glaucoma and dry eye be treated with artificial tears before VF testing to obtain accurate VF results to really graduate the level of glaucoma and adapt the treatment.

Dry eye syndrome associated with glaucoma might lead to ocular discomfort and low-quality retinal images which can decreased compliance of treatment, and deteriorate the VF test results.

Protecting the integrity of the ocular surface while treating ocular conditions like glaucoma is necessary. Eye drops with additional ocular-surface-protective properties should become a part of an ophthalmologist's armamentarium for patients at risk for ocular surface diseases requiring long-term treatment with drops.

The development of preservative-free antiglaucoma medications or medications with less toxic preservatives is likely to benefit patients, reducing ocular surface changes and possibly improving their quality of life.