Impact of topical glaucoma medications on the ocular surface and adnexa

Ocular surface disease (OSD) is a major and often unrecognized issue in patients with glaucoma. The prevalence of ODS symptoms in glaucoma patients is between 48% and 59%. The prevalence of ODS signs in glaucoma patients stretches from 22% for corneal fluorescein staining until 78% for tear film BUT. Possible risk factors for OSD in glaucoma include female gender, higher age, pre‐existing DED, glaucoma itself, glaucoma type, glaucoma duration, number of glaucoma medications and frequency of instillation, active ingredient of glaucoma drug, preservatives esp. Benzalkonium chloride in glaucoma drug, and glaucoma filtration surgery.