title: Prevalence of ocular surface disease in glaucoma patients.
abstract: OBJECTIVE
  To examine the prevalence of ocular surface disease (OSD) in glaucoma patients.
  
  
  METHODS
  This was a cross-sectional study. One hundred and one patients, 18 years of age or older, with open-angle glaucoma or ocular hypertension were consecutively recruited for the study. Patients with a history of use of cyclosporine, steroids, topical ocular nonsteroidal anti-inflammatory drugs, or punctal plugs within the last 3 months were excluded. Each patient completed an Ocular Surface Disease Index questionnaire and underwent evaluation by Schirmer test, corneal and conjunctival lissamine green staining, and tear break-up time.
  
  
  RESULTS
  Using Ocular Surface Disease Index for measuring symptoms of dry eye, 60 (59%) patients reported symptoms in at least 1 eye. Severe symptoms were reported by 27 (27%) patients. Schirmer testing showed 62 (61%) patients with decrease in tear production in at least 1 eye. Severe tear deficiency was presented in 35 (35%) patients. Corneal and conjunctival lissamine green staining showed positive results in 22 (22%) patients. None had severe staining. Tear break-up time showed abnormal tear quality in 79 (78%) patients and severe decrease in tear quality was found in at least 1 eye in 66 (65%) patients. Multivariate logistic regression models were used to investigate the association between the number of benzalkonium chloride (BAK)-containing eyedrops and results on the clinical tests of OSD. After adjustment for age and sex, each additional BAK-containing eyedrop was associated with an approximately 2 times higher odds of showing abnormal results on the lissamine green staining test (odds ratio=2.03; 95% confidence interval: 1.06 to 3.89; P=0.034).
  
  
  CONCLUSIONS
  A large proportion of patients with open-angle glaucoma or ocular hypertension had signs and/or symptoms of OSD in at least 1 eye. The coexistence of OSD and the use of BAK-containing medications may impact vision-related quality of life in this patient population.
authors.affiliation: Department of Ophthalmology, Hamilton Glaucoma Center, University of California, San Diego, La Jolla, CA 92093-0946, USA.
authors.forename: Eamon W
authors.initials: EW
authors.lastname: Leung
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Medeiros
authors.forename: Robert N
authors.initials: RN
authors.lastname: Weinreb
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001548:Benzalkonium Compounds / Q000008:administration & dosage; D004396:Coloring Agents / Q000378:metabolism; D003228:Conjunctiva / Q000378:metabolism; D003315:Cornea / Q000378:metabolism; D003430:Cross-Sectional Studies; D015352:Dry Eye Syndromes / Q000453:epidemiology*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D007429:Intraocular Pressure; D008086:Lissamine Green Dyes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy / Q000453:epidemiology; D011310:Preservatives, Pharmaceutical / Q000008:administration & dosage; D015995:Prevalence; D011795:Surveys and Questionnaires
chemical_list: D000959:Antihypertensive Agents; D001548:Benzalkonium Compounds; D004396:Coloring Agents; D008086:Lissamine Green Dyes; D011310:Preservatives, Pharmaceutical