Ocular Surface Assessment of Glaucoma Drug Tolerance

Abstract

Glaucoma topical treatments may cause mild to very severe damage to the ocular surface. Treatments induce both allergic and nonallergic inflammation, and the complex interaction between the two mechanisms varies according to the number of eyedrops used. Their toxicity is mainly associated with the preservatives used in the preparations, rather than the drugs themselves. The lower the exposure of an eye to preservatives, the less the inflammation at the ocular surface. Fixed combinations contain less preservative than the two component agents used separately, and are less likely to induce an inflammatory reaction. In addition, timolol seems to confer a protective effect against the toxicity of the preservative benzalkonium chloride.