Cross-sectional Study to Assess Ocular Surface and Tear Film Status in Patients on Topical Antiglaucoma Therapy

Aim and background: To assess ocular surface and tear film status in patients on topical antiglaucoma medication. When monotherapy proves insufficient, polytherapy and drug combinations are used. Long-term use of multiple topical medications is correlated with ocular irritation and tear film instability. Materials and methods: This observational cross-sectional study involved 81 eyes from 43 patients receiving antiglaucoma medications. Among them, 18 patients (<i>n</i> = 34) were using single medications, while 25 patients (<i>n</i> = 47) were on two or more medications. The assessment included corneal staining with fluorescein, impression cytology of the conjunctiva, the Schirmer test, and tear film break-up time (TBUT). Results: The percentage of ocular surface alterations varied from 9 to 70%, and abnormal tear film status varied from 32 to 72%. The subjects in the polytherapy group had higher corneal staining (70 vs 47%, <i>p</i> = 0.0354, significant) and abnormal (72 vs 59%, <i>p</i> = 0.0005, significant). The percentage of abnormal impression cytology reports (9 vs 4%, <i>p</i> = 0.4804) and Schirmer test results were almost equal in both groups. Conclusion: Ocular surface disorders (OSD) are more common in polytherapy, as they are in all antiglaucoma medication users. However, the tear film status is more significantly affected in subjects on polytherapy.