title: Prevalence of ocular symptoms and signs with preserved and preservative free glaucoma medication.
abstract: OBJECTIVE
  To determine the incidence of ocular toxicity of preservatives with glaucoma medications.
  
  
  METHODS
  A prospective epidemiological survey was carried out in 1999 by 249 ophthalmologists on 4107 patients. Ocular symptoms, conjunctiva, cornea, and eyelids were assessed. A chi(2) test was used for differences between preserved eye drops (P) and preservative free eye drops (PF).
  
  
  RESULTS
  84% patients used P, 13% received PF, and 3% a combination of P and PF eye drops. All symptoms were more prevalent with P than with PF drops (p<0.001): discomfort upon instillation (43% versus 17%), and symptoms between instillations such as burning-stinging (40% versus 22%), foreign body sensation (31% versus 14%), dry eye sensation (23% versus 14%), tearing (21% versus 14%), and eyelid itching (18% versus 10%). An increased incidence (>2 times) of ocular signs was seen with P eye drops. The prevalence of signs and symptoms was dose dependent, increasing with the number of P drops. A reduction in the symptoms and signs was observed when patients changed from P to PF eye drops (p<0.001).
  
  
  CONCLUSIONS
  Symptoms and signs are less prevalent when PF drops are used. Moreover, most of the adverse reactions induced by P glaucoma medication are reversible after removing preservatives.
authors.affiliation: APHP Ambroise Paré Hospital, University Paris V, Ophthalmology Department, 9, avenue Charles de Gaulle, 92100 Boulogne, France.
authors.forename: P J
authors.initials: PJ
authors.lastname: Pisella
authors.forename: P
authors.initials: P
authors.lastname: Pouliquen
authors.forename: C
authors.initials: C
authors.lastname: Baudouin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005128:Eye Diseases / Q000139:chemically induced*; D005260:Female; D005602:France / Q000453:epidemiology; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000009:adverse effects*; D011310:Preservatives, Pharmaceutical / Q000009:adverse effects*; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical