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Topical glaucoma medications linked to increased tear osmolarity
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Tear osmolarity increased in patients who underwent medical treatment for glaucoma or ocular hypertension, according to a study.
“Medical therapy is the usual first-line treatment for glaucomatous patients, and most patients with chronic glaucoma or ocular hypertension are treated medically,” the study authors said. “However, chronic use of topical intraocular pressure-lowering drugs and their preservatives is known to cause significant changes on the ocular surface.”
The study included 40 patients with a mean age of 63.9 years who underwent medical treatment for glaucoma or ocular hypertension. Patients completed the Ocular Surface Disease Index (OSDI) and underwent measurement of tear film osmolarity and tear breakup time. They also underwent Schirmer testing, corneal staining and conjunctival staining.
OSDI scores showed that 24 patients (60%) reported ocular surface disease symptoms; 12 patients (30%) reported severe symptoms. Schirmer test results showed tear deficiency in 20 patients (50%); six patients (15%) had severe tear deficiency.
Tear osmolarity strongly correlated with OSDI scores (P = .002) and tear breakup time (P = .009).
Results showed abnormal tear quality in 27 patients (67.5%) and severely reduced tear breakup time in four patients (10%). Positive staining was seen in 16 patients (40%).
Patients with severe symptoms had significantly higher osmolarity than those with normal (P = .016) or mild to moderate symptoms (P = .015).
Data showed statistically significant correlations between tear osmolarity and number of drugs (P = .009), number of instillations (P = .01) and number of instillations of preserved eye drops (P < .0001), the authors said.
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