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Ocular surface disease in glaucoma patients

Poster Details

First Author: M.R SERBIA

Co Author(s):    G. Stankovic Babic   P. Jovanovic   B. Dzunic   J. Djordjevic Jocic   M. Trenkic Bozinovic  

Abstract Details


Prolonged and combined glaucoma topical therapy causes exacerbation of subclinical symptoms of dry eye due to containing preservatives or parent drugs. The aim of these work is to estimate the incidence of Ocular Surface Disease (OSD) in glaucoma patients after administration of antiglaucoma drugs with preservatives (mostly benzalkonium chloride-BAK containing eyedrops), in various period of time in a group of patients suffering from glaucoma simplex and capsulare, compared to health control group. To estimate Dry Eye-multifactorial disease of the tears and ocular surface, that results in symptoms of discomfort, visual disturbance, tear film instability with potential damage to the ocular surface, accompanied by increased tear film osmolarity and inflammation of the ocular surface.


This research (patient testing/examination) was performed in glaucoma department of Eye Clinic(ClinicalCentreNis)


Descriptive statistic analysis of results obtained examining 45 patients ( 90 eyes: 30 glaucoma simplex, 30 glaucoma capsularae and 30 healthy). Used diagnostic protocol included: Ocular Surface Disease Index- each patient completed questionnaire and values calculated using OSDI formula; and underwent clinical evaluation by TBUT, Schirmer test, vital staining (Rose Bengal test evaluated according to Oxford Grading scheme), slit lamp, Delphi Panel scale grading system according to symptoms and clinical signs.


Based on OSDIndex symptom score, measuring dry eye symptoms in group of glaucoma simplex 33,3%normal was reported, 40%mild, without moderate and 26,7%severe. In Glaucoma capsulare group: 6,7%normal , 40%mild, 26,7% moderate, 26,7%severe. Control healthy group distribution: 60%normal and 40%mild. Delphi Panel Grading Scale in gl.simplex:23,3%(gradus I), 23,3%(gradus IIa), 50%(gradus IIb), 3,4%(gradus III). Gl.capsulare 23,3%(gradus IIa), 60%(gradus IIb), 16,7%(gradus III). Control group:60%normal 13,3%(gradus I), 10%(gradus IIa), 16,7%(gradus IIb). Incidence of OSD according to number of antiglaucoma bottles in gl.simplex 20%(1drug), 33,3%(2drugs), 46,7%(3drugs); Gl.capsulare 33,3%(1drug), 46,7%(2drugs), 20%(3drugs).Therapy duration less than 5 years:66,7%(gl.simplex) and 100%(gl.capsulare), longer than 5 years 33,3%(gl.simplex).


Higher incidence of OSD with mild and moderate gradus in groups of simplex and capsularae glaucoma vs. health control group. According to Delphi Panel Scale the highest incidence was in glaucoma capsulare (IIb and III). The most frequent gradus was IIb including all three groups. There was no difference due to duration of therapy. Higher incidence of using three bottles of drugs suggests administration of fixed and preservative-free drug formulations.The coexistence of Ocular Surface Disease and the administration of BAK-containing medications may impact quality of life in this patient population.

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