Dry Eye Disease Symptoms Among Portuguese Glaucoma Patients

Glaucoma-related dry eye disease is often underestimated but it is an important co-morbidity in glaucoma patients. The main purpose of this investigation was to study a group of Portuguese glaucoma patients regarding the presence of dry eye disease symptoms and correlate it with the usage of different glaucoma topical medications. 

Department of Ophthalmology, Unidade Local de Saúde Entre o Douro e Vouga, Santa Maria da Feira, Portugal.

Cross-sectional observational study in patients diagnosed with primary and secondary open-angle glaucoma. The questionnaire Standardized Patient Evaluation of Eye Dryness (SPEED) translated to Portuguese (SPEED-Vp) was done to patients followed by the glaucoma department of our hospital. Data was collected regarding their age, gender, type of topical medication in use as well as frequency and duration of usage. A statistical analysis was performed.

75 patients answered the questionnaire. Mean age was 72 ± 7 years old. 52% were male. 49.33% had been on intraocular pressure-lowering eyedrops for more than 5 years. 61.43% of patients used eyedrops with preservatives. Most of the patients used prostaglandin analogs (75.71%) and beta blockers (72.86%). 25.33% had no dry eye symptoms, 58.67% had mild symptoms, 8% had moderate symptoms and 8% had severe symptoms. No statistically significant correlation was found between SPEED score and age, gender, number of eyedrop containers, number of active principles, application frequency, presence of preservatives, number of eyedrop containers with preservatives, duration of eyedrops usage or any of the medication groups.

Although a high percentage of patients were on eyedrops with preservatives, the rate of symptoms reported might be because patients with a severe disease like glaucoma tend to devalue these symptoms; or were already on treatment with artificial tears; or have an underestimation of the sensation of dry eye due to decreased neuronal corneal nerve responses and density. However, these results were surprisingly positive and this might also be the result of the healthcare provider’s sensibilization to this issue (early diagnosis, early prescription of artificial tears and change from preservative to preservative-free medication).