4.4 Review

New strategies for the management of ocular surface disease in glaucoma patients

Journal

CURRENT OPINION IN OPHTHALMOLOGY
Volume 32, Issue 2, Pages 134-140

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ICU.0000000000000739

Keywords

glaucoma; intense pulse light; meibomian gland disease; minimally invasive glaucoma surgery; ocular surface disease

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Glaucoma patients often suffer from ocular surface disease (OSD), which can affect diagnostic tests, medication compliance, and quality of life. Recent research has shown the importance of considering both glaucoma and OSD in the management of these complex patients.
Purpose of review Glaucoma patients commonly suffer from ocular surface disease (OSD). As treatment strategies, medications and devices for the treatment of OSD as well as glaucoma surgical approaches evolve rapidly, it is important to consider their application to these patients. Recent findings OSD in glaucoma patients may lead to reduced reliability of diagnostic tests, decreased medication compliance, poor surgical outcomes, and overall decreased quality of life. Chronic use of topical glaucoma medications has been linked to the development of limbal stem cell deficiency, and the role of preservatives in OSD continues to be demonstrated. Preservative free glaucoma medications as well as new anti-inflammatory agents for the treatment of OSD are now available. Omega-3 fatty acid supplementation and punctal plugs have been shown to benefit glaucoma patients with OSD. Drop burden may be reduced through the use of the new sustained-release delivery systems, selective laser trabeculoplasty, and minimally invasive glaucoma surgery. There are multiple emerging strategies for managing OSD that may be applied to patients with glaucoma. With continued research and clinical experiences, we hope to better understand the multifaceted relationship between glaucoma and OSD and develop evidence-based algorithms for the management of these complex patients.

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