Glaucoma-related ocular surface disease
(G-OSD) is a common, multifaceted, and visually significant ocular co-morbidity.
The prevalence of dry eye varies worldwide
from 8% to 30% in the normal population, with an increased prevalence in South
East Asian populations.
However, the prevalence of OSD in the
glaucoma population varies from 40% to 59%.
Asian populations tend to have a higher
prevalence of G-OSD, with a greater incidence of tear break-up time (TBUT)
alteration and increased corneal staining.
An unhealthy ocular surface can adversely
affect the ocular structures and the patient's quality of life (QOL).
The utility scores for moderate to severe Dry
Eye Syndromes (DES) are comparable to those of angina and dialysis. Utility
scores quantify how many years a patient would give up from the end of their
lives to avoid a certain illness.
DES and glaucoma are both associated with a
high prevalence of mood disorders, depression, and anxiety.
Dry eye symptoms in glaucoma patients have
a substantial social, economic, and public health burden.
A study from Australia reported that 39% of
patients with glaucoma suffered from significant dry eye disease, and the
associated economic burden was calculated to be 330.5 million AU$ per year.
Even if visual acuity is normal according
to Snellen's measurements, the instability of the tear film generates
aberrations that may result in an alteration of visual function and a decrease
in the visual quality.
Fluctuations in the tear film can also increase
irregular astigmatism and impair visual performance, resulting in worsening
contrast sensitivity and visual acuity.
The poor ocular surface may affect the
reliability of perimetry.
Glaucoma and dry eye patients with poor
total OSDI scores usually have greater visual difficulty with text-based
search.
The pathogenesis of dry eye can be
characterized as a vicious cycle: once induced, numerous inflammatory
mechanisms are triggered and tend to self-perpetuate.
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