Aim: Topical antiglaucoma drugs may have adverse effects on the ocular surface. In this study, our aim was to report the frequency of dry eye and the use of artificial tear drops in patients diagnosed with glaucoma and using topical antiglaucoma drugs. We also evaluated factors affecting this association.

Methods: Based on the medical records, we selected patients admitted to the ophthalmology department between 2020 and 2021 who had been diagnosed with glaucoma. In this study, we included patients who were using topical antiglaucoma medications and were older than 40 years of age. Age, gender, type, and number of glaucoma medications used, dry eye diagnosis, and use of artificial tear drops and/or topical cyclosporine were recorded.

Results: We found that 346 (27%) of the 1,274 patients using topical antiglaucoma drugs had dry eyes and were using artificial tear drops. Gender (female) and the number of antiglaucoma medications used were associated with an increased risk of dry eye in these patients, while increasing age was not associated with dry eye.

Conclusion: Dry eye is common in patients using topical antiglaucoma medications and should be considered in the treatment of glaucoma.

Keywords: antiglaucoma medications, artificial tear drops, dry eye, glaucoma, ocular surface disease

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How to cite

Küçük E, Zor KR, Çoban Karataş M, Yıldırım Biçer G. Prevalence of dry eye in patients using topical antiglaucoma medications. Northwestern Med J. 2024;4(2):101-5. https://doi.org/10.54307/2024.NWMJ.113


  1. Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012; 96(5): 614-8. https://doi.org/10.1136/bjophthalmol-2011-300539
  2. Flaxman SR, Bourne RRA, Resnikoff S, et al. Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis. Lancet Glob Health. 2017; 5(12): e1221-34. https://doi.org/10.1016/S2214-109X(17)30393-5
  3. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014; 121(11): 2081-90. https://doi.org/10.1016/j.ophtha.2014.05.013
  4. Prum BE, Rosenberg LF, Gedde SJ, et al. Primary Open-Angle Glaucoma Preferred Practice Pattern(®) Guidelines. Ophthalmology. 2016; 123(1): P41-111. https://doi.org/10.1016/j.ophtha.2015.10.053
  5. Tanna AP, Lin AB. Medical therapy for glaucoma: what to add after a prostaglandin analogs? Curr Opin Ophthalmol. 2015; 26(2): 116-20. https://doi.org/10.1097/ICU.0000000000000134
  6. Erb C, Gast U, Schremmer D. German register for glaucoma patients with dry eye. I. Basic outcome with respect to dry eye. Graefes Arch Clin Exp Ophthalmol. 2008; 246(11): 1593-601. https://doi.org/10.1007/s00417-008-0881-9
  7. Garcia-Feijoo J, Sampaolesi JR. A multicenter evaluation of ocular surface disease prevalence in patients with glaucoma. Clin Ophthalmol. 2012; 6: 441-6. https://doi.org/10.2147/OPTH.S29158
  8. Costa VP, da Silva RS, Ambrósio R. The need for artificial tears in glaucoma patients: a comparative, retrospective study. Arq Bras Oftalmol. 2013; 76(1): 6-9. https://doi.org/10.1590/s0004-27492013000100003
  9. Zhang X, Vadoothker S, Munir WM, Saeedi O. Ocular Surface Disease and Glaucoma Medications: A Clinical Approach. Eye Contact Lens. 2019; 45(1): 11-8. https://doi.org/10.1097/ICL.0000000000000544
  10. Skalicky SE, Goldberg I, McCluskey P. Ocular surface disease and quality of life in patients with glaucoma. Am J Ophthalmol. 2012; 153(1): 1-9.e2. https://doi.org/10.1016/j.ajo.2011.05.033
  11. Stringham J, Ashkenazy N, Galor A, Wellik SR. Barriers to Glaucoma Medication Compliance Among Veterans: Dry Eye Symptoms and Anxiety Disorders. Eye Contact Lens. 2018; 44(1): 50-4. https://doi.org/10.1097/ICL.0000000000000301
  12. Banitt M, Jung H. Ocular Surface Disease in the Glaucoma Patient. Int Ophthalmol Clin. 2018; 58(3): 23-33. https://doi.org/10.1097/IIO.0000000000000232
  13. Friedman DS, Wolfs RC, O'Colmain BJ, et al. Prevalence of open-angle glaucoma among adults in the United States. Arch Ophthalmol. 2004; 122(4): 532-8. https://doi.org/10.1001/archopht.122.4.532
  14. Moss SE, Klein R, Klein BE. Prevalence of and risk factors for dry eye syndrome. Arch Ophthalmol. 2000; 118(9): 1264-8. https://doi.org/10.1001/archopht.118.9.1264
  15. Fechtner RD, Godfrey DG, Budenz D, Stewart JA, Stewart WC, Jasek MC. Prevalence of ocular surface complaints in patients with glaucoma using topical intraocular pressure-lowering medications. Cornea. 2010; 29(6): 618-21. https://doi.org/10.1097/ICO.0b013e3181c325b2
  16. Stapleton F, Alves M, Bunya VY, et al. TFOS DEWS II Epidemiology Report. Ocul Surf. 2017; 15(3): 334-65. https://doi.org/10.1016/j.jtos.2017.05.003
  17. Lichter PR, Musch DC, Gillespie BW, et al. Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study comparing initial treatment randomized to medications or surgery. Ophthalmology. 2001; 108(11): 1943-53. https://doi.org/10.1016/s0161-6420(01)00873-9
  18. Pisella PJ, Pouliquen P, Baudouin C. Prevalence of ocular symptoms and signs with preserved and preservative free glaucoma medication. Br J Ophthalmol. 2002; 86(4): 418-23. https://doi.org/10.1136/bjo.86.4.418
  19. Steven DW, Alaghband P, Lim KS. Preservatives in glaucoma medication. Br J Ophthalmol. 2018; 102(11): 1497-503. https://doi.org/10.1136/bjophthalmol-2017-311544
  20. Hedengran A, Steensberg AT, Virgili G, Azuara-Blanco A, Kolko M. Efficacy and safety evaluation of benzalkonium chloride preserved eye-drops compared with alternatively preserved and preservative-free eye-drops in the treatment of glaucoma: a systematic review and meta-analysis. Br J Ophthalmol. 2020; 104(11): 1512-8. https://doi.org/10.1136/bjophthalmol-2019-315623