• COVID-19
  • Biosimilars
  • Cataract Therapeutics
  • DME
  • Gene Therapy
  • Workplace
  • Ptosis
  • Optic Relief
  • Imaging
  • Geographic Atrophy
  • AMD
  • Presbyopia
  • Ocular Surface Disease
  • Practice Management
  • Pediatrics
  • Surgery
  • Therapeutics
  • Optometry
  • Retina
  • Cataract
  • Pharmacy
  • IOL
  • Dry Eye
  • Understanding Antibiotic Resistance
  • Refractive
  • Cornea
  • Glaucoma
  • OCT
  • Ocular Allergy
  • Clinical Diagnosis
  • Technology

Glaucoma Medications and Dry Eye Disease


Eye care experts highlight the impact of glaucoma medications on dry eye disease and strategies for management.


Marguerite McDonald, MD, FACS: The dry eye patient who’s on a glaucoma medication, Rich, you touched on it before. There are quite a few peer-reviewed publications indicating that that leads to noncompliance and loss of visual field, etcetera, because of the terrible discomfort of putting a glaucoma drop on a dry eye.

Richard Mangan, OD, FAAO: Yes, and I see that unfortunately a lot as well. And I hear arguments on both ends, that lowered cost should lead to greater compliance. At the same time, if it’s a product that’s not beneficial to the ocular surface, they oftentimes won’t use it and sometimes stop more than just 1 offending agent. They’re not sure which 1 it is.

Marguerite McDonald, MD, FACS: Stop them all.

Richard Mangan, OD, FAAO: They’re less compliant with all of them, and again, that’s where patient education is very important about if there’s any concern about how a drop is feeling on the eye, that they need to let us know.

Marguerite McDonald, MD, FACS: Does that lead you more toward non-preserved unit dose BAK [benzalkonium chloride]-free medicines?

Eric Donnenfeld, MD, FACS: Of course you want to minimize the number of drops the patient receives, so a once-a-day glaucoma drop is better than a twice-a-day glaucoma drop, which is of course better than a three-times-a-day glaucoma drop. Limit the BAK. For patients who have significant dry eye problems, you can start them on non-preserved drops. But very commonly when I have a patient who has dry eye to start with and we’re starting glaucoma therapy, I think it’s really a good idea to manage their dry eye at the same time that you manage their glaucoma. Putting patients on immunosuppressive therapies concomitantly with glaucoma management I think does a great job in assuring patient satisfaction and making sure the medications stay where you want them to go. The use of lifitegrast or cyclosporine I think are really important for our glaucoma colleagues to use to make certain our patients get the right outcome.


Related Videos
Video 3 - "Approaching Asymptomatic Cases with Risk Factors"
Video 2 - "Do Dry Eye Diagnostics Change the Management of Dry Eye?"
Andrew Pucker, OD, PhD
Video 1 - "Challenging the Definition of Dry Eye- Interpreting Diagnostic Tests"
© 2024 MJH Life Sciences

All rights reserved.