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Ocular Surface Disease - Blepharitis FoundationYour resource for red eyes

Ocular Surface Disease

A recent article mentioned that “ocular surface disease” was common in people taking glaucoma eye drops. Ocular surface disease is a catch-all term for disruption of the cornea and conjunctiva, the outer “surface” of the eye.

Ocular Surface Disease

Irregular surface of the cornea and conjunctiva is obvious when a drop of dye is instilled.

It is well known that dryness, allergy, eye drops, and blepharitis, can all cause ocular surface disease. The fact that glaucoma eye drops are associated with ocular surface disease should come as no surprise. Glaucoma eye drops are potent medications which lower intraocular pressure. Potent medications often have potent side effects, including irritancy, or toxicity. In general, the toxicity is minimal. Eye drops are formulated with buffers, and stabilizers, so they are mostly well tolerated. But they must contain the required drug in adequate concentrations, and they must contain preservatives so they do not become contaminated. Since many different kinds of drops are used to treat glaucoma, a less toxic drop can sometimes be substituted for a toxic one. This is frequently done when a patient develops intolerance to a particular glaucoma drop. If a satisfactory substitute cannot be found, glaucoma surgery can often be done, and the need for glaucoma drops can often be eliminated. It is worth repeating that glaucoma eye drops can also have toxicity for the eyelids. So, patients with glaucoma can develop blepharitis from their eye drops. Occasionally, the eyelid inflammation is caused by allergy, or contact dermatitis. More often, it is caused by direct irritancy of the drug, acting on the delicate skin of the eyelid.

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