Management of glaucoma in patients with ocular surface disease

• Published in: Acta ophthalmologica (Oxford, England) Vol. 102; no. S279
• Main Author: Cvenkel, Barbara
• Format: Journal Article
• Language: English
• Published: Malden Wiley Subscription Services, Inc 01.01.2024
• Subjects: Disease; Disease management; Eye diseases; Glaucoma; Medical treatment; Older people; Patients; Preservatives; Visual field; Visual perception
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/aos.16352

Glaucoma and ocular surface disease (OSD) are common diseases in the elderly population. As the prevalence of both conditions increases with age, they often occur together and can present in a spectrum of disease ranging from mild to severe. The management of glaucoma in patients with OSD is challenging, especially when the treatment of glaucoma, for which topical medications are usually the first choice, can further compromise the ocular surface and exacerbate the signs and symptoms of dry eye disease. In patients with glaucoma and co‐existing ocular surface disease, both need to be treated, depending on the severity of each disease and the likelihood of loss of visual function. Frequent visual field testing is required to monitor and assess the progression of glaucoma. In patients with OSD, the visual field is often unreliable and makes it difficult to diagnose and detect the progression of glaucoma. In early to moderate open‐angle glaucoma or ocular hypertension, selective laser trabeculoplasty is a good option for initial treatment as it delays the need for topical treatment. In advanced disease, the lowest number of preservative‐free eye drops should be prescribed, or glaucoma surgery should be performed.