THE IMPACT OF ANTIGLAUCOMA AGENTS ON THE OCULAR SURFACE IN 180 GLAUCOMA PATIENTS.

Identify interactions between the ocular surface and antiglaucoma drugs and propose practical attitudes to prevent and manage the resulting adverse effects.

This is a retrospective study in the ophthalmology department at -20 Aout- Hospital in Casablanca. Chronic glaucoma patients followed regularly in specialized consultation from January 2020 to January 2022 were included. Patients who presented with corneal damage, or were followed for ocular surface pathology, were excluded.

180 patients were included in this study. They were all questioned with simple and precise questions concerning their functional symptoms ( blurred vision, feeling of grain of sand, tearing). They benefited from a careful ophthalmological examination and  a shirmer test was performed.

The average age of our patients was 55 years, with a sex ratio of 0.6. The prevalent functional sign was an allergic reaction with visual blur. Average treatment period was 21 months. 57% of our patients were on dual therapy. The overall prevalence of dry syndrome was 60% with an average break up time (BUT) of 5 seconds and a reduced lacrymal secretion tested by the Schirmer test. The results were as follows:  4% had a Schirmer test under 5 mm, 17% between 5 and 10 mm whereas 16% were between 10 and 15mm. The associated factors were advanced age (56%), the use of preservative eye drops (80%). Beta blockers were statistically related to the occurrence of conjunctival hyperhemia and the alteration of the break-up time.

The damage to the ocular surface depends on the length of time the glaucoma has been evolving, the number of therapies used, with or without conservative. Preference should be given to fixed combinations, without conservative while adopting a subtraction strategy: reduce or stop the therapeutic components, rather than adding eye drops intended to attenuate or mask the side effects of eye drops antiglaucoma